I?ntraabdominal Testisli Çocuklarda Spermatik Damarları Ayırmadan Tek Aşamalı Laparoskopik Orşiopeksi
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Dosyalar
Tarih
2006
Yazarlar
Dergi Başlığı
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı intraabdominal testisi olan çocuklarda, spermatik damarları ayırmadan uygulanan tek aşamalı laparoskopik orşiopeksi (LO)'nin etkinliğini ve avantajlarını belirlemektir. Yöntem: Palpe edilemeyen testis nedeniyle tanısal laparoskopi uygulanan hastalardan, testisleri intraabdominal pozisyonda olan 9 hastaya (10 testis) tek aşamalı LO uygulandı. Olguların yaşları 7 ay ile 13 yıl (ortalama yaş: 6 yıl) yıl arasında değişiyordu. İki olguda (% 22.2) aynı tarafta inguinal herni de vardı. Ameliyatta üç trokar kullanıldı. Spermatik damarlar, vaz deferens ve gubernakulum serbestleştirildi. Testisler, internal inguinal halka açıksa buradan, açık değilse internal inguinal halkanın medialinden yeni bir inguinal kanal oluşturularak skrotum içine çekildi. Testis skrotumda dartos altına yerleştirildi. Hastalar ameliyattan sonra ortalama 9 ay (6 ay-3 yıl) takip edildi. Bulgular: Testislerin internal inguinal halkaya uzaklığı 0-2 cm arasında idi. İntraoperatif komplikasyon olarak, inguinal herni onarımı yapılan iki hastada inguinal ve skrotal bölgede cilt altı anfizemi oluştu. Ameliyat süreleri 45-80 (ortalama 65) dk arasında idi. Olguların hastanede kalış süreleri 2 ile 4 (ortalama 3,3) gün arasında değişiyordu. Takip süresince bütün testisler skrotumdaydı ve hastaların hiçbirinde testis atrofisine rastlanmadı. Sonuç: Tek aşamalı LO, testisleri internal inguinal halkaya uzaklığı 3 cm'den daha yakın olan olgularda başarılı bir şekilde uygulanabilir. İşlemin laparoskopik olarak yapılması ile laparoskopik girişimin avantajlarından da yararlanılabilir.
Aim: The objective of this study was to determine the effectiveness and advantages of one-stage laparoscopic orchiopexy (LO) performed without dividing the spermatic vessels in children with intraabdominal testes. Method: One-stage LO was performed in nine (10 testes) of the patients who underwent laparoscopic diagnostic exploration because of nonpalpable testes. Patient age ranged from 7 months to 13 years (mean age 6 years). We also encountered an ipsilateral inguinal hernia in two cases (22.2 %). Three trocars were used during the operation. The technique consists of mobilization of the spermatic vessels and the vas deferens, dividing the gubernaculum. The testis was brought into the scrotum through the internal inguinal ring if open, or through the new inguinal canal formed medial to the internal inguinal ring if closed. It was fixed in a subdartos pouch. The follow-up period was between 6 months to 3 years (mean 9 months). Results: The testes were at a distance of approximately 0 to 2 cm to the internal inguinal ring. The subcutaneous emphysema was determined in the inguinal and scrotal area in two cases who underwent an inguinal hernia repair. The operating time was between 45 and 80 minutes (mean 65 minutes). The postoperative length of stay was 2 to 4 days (mean 3.3 days). At follow-up, all testes were without atrophy and located in scrotal position. Conclusions: The one-stage LO can be performed successfully in the cases whose intraabdominal testis is at less than 3 cm distance to the internal inguinal ring. The advantages of laparoscopic approach can be utilized with the application of this technique laparoscopically.
Aim: The objective of this study was to determine the effectiveness and advantages of one-stage laparoscopic orchiopexy (LO) performed without dividing the spermatic vessels in children with intraabdominal testes. Method: One-stage LO was performed in nine (10 testes) of the patients who underwent laparoscopic diagnostic exploration because of nonpalpable testes. Patient age ranged from 7 months to 13 years (mean age 6 years). We also encountered an ipsilateral inguinal hernia in two cases (22.2 %). Three trocars were used during the operation. The technique consists of mobilization of the spermatic vessels and the vas deferens, dividing the gubernaculum. The testis was brought into the scrotum through the internal inguinal ring if open, or through the new inguinal canal formed medial to the internal inguinal ring if closed. It was fixed in a subdartos pouch. The follow-up period was between 6 months to 3 years (mean 9 months). Results: The testes were at a distance of approximately 0 to 2 cm to the internal inguinal ring. The subcutaneous emphysema was determined in the inguinal and scrotal area in two cases who underwent an inguinal hernia repair. The operating time was between 45 and 80 minutes (mean 65 minutes). The postoperative length of stay was 2 to 4 days (mean 3.3 days). At follow-up, all testes were without atrophy and located in scrotal position. Conclusions: The one-stage LO can be performed successfully in the cases whose intraabdominal testis is at less than 3 cm distance to the internal inguinal ring. The advantages of laparoscopic approach can be utilized with the application of this technique laparoscopically.
Açıklama
Anahtar Kelimeler
İnmemiş testis, Laparoskopi, Orşiopeksi, Laparoscopy, Orchiopexy
Kaynak
Çocuk Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
2
Künye
Abasıyanık, A., Yurtçu, M., Biçer, Ş., (2006). İntraabdominal Testisli Çocuklarda Spermatik Damarları Ayırmadan Tek Aşamalı Laparoskopik Orşiopeksi. Çocuk Cerrahisi Dergisi, 20(2), 117-119.
