42. Kết quả phẫu thuật nội soi điều trị ẩn tinh hoàn trong ổ bụng tại Bệnh viện Nhi Trung ương

Abstract

Cryptorchidism is among the most common congenital anomalies in male children; if not treated in a timely manner, it may impair fertility and increase the risk of testicular malignancy. This retrospective study evaluated surgical outcomes in 105 patients with 124 intra-abdominal undescended testes who underwent laparoscopy at the Vietnam National Children’s Hospital from January 2021 to June 2024. The median age was 31 months (range, 7 - 190); 25 testes were atrophic (20.16%); 9 testes were converted to an open inguinal approach (7.26%); 45 underwent single-stage laparoscopic vessel-sparing orchiopexy (36.29%); and 45 underwent two-stage laparoscopic Fowler-Stephens orchiopexy (36.29%). In all 90 laparoscopically descended testes, the internal (deep) inguinal ring was left unclosed. Postoperative follow-up was available for 61/90 laparoscopically descended testes (67.78%). The mean follow-up duration was 18.13 ± 9.17 months. Among these, 51 testes were located in the scrotum (83.61%); 7 were in a high-scrotal position (11.48%); and 3 were atrophic (4.92%). No postoperative complications were observed. Laparoscopic orchiopexy is a safe and effective treatment for intra-abdominal undescended testes in children, and the two-stage Fowler-Stephens technique should be reserved for cases with short spermatic vessels.