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对4例高位腹腔内睾丸病人施行了精索血管切断,将睾丸自体移植于阴囊的手术。一侧行显微外科血管重吻合另一侧则不作。显微外科血管重吻合防止了睾丸萎缩。以那种方法对不能触得睾丸的隐睾者定位,最好(精索静脉造影,EMI扫描或精索动脉造影)新近已有相当多的讨论。并且对高位腹腔内睾丸恰当的外科处理也存在许多争论。作者的经验,腹腔镜检查是最简便最安全,和最可靠的高位腹腔内睾丸的定位方法。外科处理是切断精索血管,置睾丸入阴囊内,许多病例,由于经输精管动脉的侧枝血供应,并不发生明显的损害。但是,当侧枝循环不足时须强调有发生睾丸萎缩的危险。新近有几例双侧腹腔内睾丸病人,他们曾在其他医院施行简单的一侧精索血管切断手术,随后发生了该侧睾丸萎缩。把这些病例的另一侧精索血管切断,用显微外科重吻合于腹壁下血管,在被切断的精索血管得以重血管化的这侧,睾丸则仍保持其正常的大小和结构。
In 4 cases of high intraperitoneal testicular spermatic cord blood vessels were cut off, the testis autologous transplantation in the scrotum surgery. One side of the microsurgery vascular re-match the other side is not made. Microsurgical vascular reassortment prevents testicular atrophy. In that way, cryptorchidism, which can not touch the testicles, has been the subject of much discussion recently (sphincterography, EMI, or sphincterography). And there is much debate about the proper surgical management of high intraperitoneal testes. The author’s experience, laparoscopy is the most simple and safest, most reliable and high intraperitoneal testicular positioning method. Surgical treatment is to cut off the spermatic vessels, placing the testis into the scrotum. In many cases, no significant damage occurs due to the supply of collateral blood via the vas deferens. However, there is a risk of testicular atrophy being emphasized when there is insufficient collateral circulation. Several recent cases of bilateral intraperitoneal testicular disease, they have been performed in other hospitals a simple stenosed angioplasty, followed by the side of the testicular atrophy occurred. The spermatic vessels on the other side of these cases were resected, reconstructed microsurgically with the inferior abdominal wall, and the testes retained their normal size and structure on the severed vascularized stenosed vessels.