【摘要翻译】切断精索血管前后腹腔内睾丸的体积和组织学发现

[文题]VOLUMETRIC AND HISTOLOGICAL FINDINGS IN INTRA-ABDOMINAL TESTES BEFORE AND AFTER DIVISION OF SPERMATIC VESSELS.
切断精索血管前后腹腔内睾丸的体积和组织学发现
[来源]Journal of Urology.
[年、卷、期、页]2004. 171(6, Part 1 of 2):2430-2433
[作者]ROSITO, NICOLINO CESAR; KOFF, WALTER JOSE; OLIVEIRA, TAISMAR LILIANE DA SILVA; CERSKI, CARLOS TADEU; SALLE, JOAO LUIZ PIPPI
[原文摘要]
Purpose: Increased use of video laparoscopy in the diagnosis and treatment of the impalpable testis has encouraged use of the 2-stage Fowler-Stephens orchiopexy. To date, however, few limited studies exist to indicate whether clipping and division of the spermatic vessels alone may cause histological abnormalities in the intra-abdominal testis.
Materials and Methods: We evaluated histology and volume of 44 intra-abdominal testes in 35 patients between 4 months and 14 years old at stages 1 and 2 of the Fowler-Stephens procedure.
Results: There was a significant reduction in the number of spermatogonia and seminiferous tubules 6 months after ligation and division of the spermatic vessels. No differences were found in the number of Sertoli cells or testicular volume before and after clipping and division of the spermatic vessels.
Conclusions: Ligation of the spermatic vessels during stage 1 orchiopexy for intra-abdominal testicles is associated with a significant reduction of spermatogonia. However, no significant changes were observed in the volumetric characteristics of the testicles. Further studies are necessary to evaluate the repercussions of these changes in future fertility.

[中文译文]
目的：随着电视腹腔镜对不可触及的隐睾诊断和治疗的增加使2期Fowler-Stephens睾丸固定术的应用得以促进。但是少有研究提示单独钳加和切断精索血管是否可以引起腹腔内睾丸的组织学的异常。
材料与方法：评估35例年龄在4月到14岁的患者44个腹腔内睾丸在Fowler-Stephens一期和二期手术时的组织学情况和体积。
结果：结扎和切断精索血管6月后睾丸精原细胞和曲细精管的数目明显减少。但在结扎和切断精索血管前后Sertoli细胞和睾丸体积无明显变化。
结论：在腹腔内睾丸的1期固定中结扎精索血管与精原细胞数目明显减少有关。但是睾丸的体积无明显变化。此种改变对未来生育的影响有待进一步研究。
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[个人评论]Fowler-Stephens手术简介：根据睾丸双重血供的原理（精索血管和输精管血管），对精索短、保留精索难以下降至阴囊的腹腔内睾丸进行二期手术，一期切断精索，待6月后将睾丸下降固定于阴囊内。常规要求切断精索前先阻断精索观察睾丸血供。现在应用腹腔镜后，一期手术借助腹腔镜完成。但是该手术的远期对生殖的影响尚无大宗报道。