41. Đặc điểm lâm sàng và chẩn đoán hình ảnh bệnh nhi ẩn tinh hoàn trong ổ bụng điều trị bằng phẫu thuật nội soi

Abstract

Cryptorchidism is one of the most common congenital anomalies in boys; without early detection and treatment, it can impair fertility and increase the risk of testicular cancer. We conducted a retrospective study describing the clinical and imaging features of 105 children with intra-abdominal undescended testes who underwent laparoscopic surgery at the National Children’s Hospital from 01/2021 to 06/2024. The median age at surgery was 31 months (7 - 190 months). Associated anomalies were present in 26/105 patients (24.76%), most commonly pathology related to a patent processus vaginalis. On physical examination, 100% had an underdeveloped/empty hemiscrotum, and the affected testis was nonpalpable in the scrotum and inguinal canal. Ultrasound was performed in all cases, yielding a sensitivity of 63.64% and a specificity of 68.00%. No patient underwent CT or MRI for testicular localization. Among children ≤ 6 years, compensatory hypertrophy of the contralateral (healthy) testis predicted atrophy of the affected testis, with an AUC of 0.847 at a threshold of 0.75mL (sensitivity 82%, specificity 92%). While ultrasound and clinical examination are valuable in the initial assessment, diagnostic laparoscopy remains the gold standard for confirming intra-abdominal undescended testes.