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العنوان
Surgical and morphological outcome of one stage
laparoscopic orchidopexy with preservation of
gubernaculum and interruption of testicular vessels in
comparison to two stages Fowler – Stephens’s orchidopexy
technique with preservation of gubernaculum for
impalpable testis /
المؤلف
El Kashory, Ahmed Ibramim.
هيئة الاعداد
باحث / أحمــــد إبـــراهيـــــــــم الكــــاشــــــوري
مشرف / سامح عبدالحي عبدالحميد
مشرف / خالد محمد الاسمر
مشرف / محمد سعيد الشربيني
تاريخ النشر
2023.
عدد الصفحات
105 P. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
جراحة
تاريخ الإجازة
1/1/2023
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم طب وجراحة الاطفال
الفهرس
Only 14 pages are availabe for public view

from 104

from 104

Abstract

This was a Randomized controlled clinical trial (RCT), conducted on 50 non-palpable undescended testes; to compare the outcome of one stage laparoscopic orchidopexy with interruption of testicular vessels and preservation of the gubernaculum to two stage laparoscopic Fowler – Stephens’s orchidopexy with preservation of the gubernaculum.
The primary (dependent) outcome of this study was the rate of testicular atrophy, which defined as palpation of a nubbin or the inability to palpate a testis (complete atrophy) on postoperative physical examination at 3, 6 and 9 months.
Ultrasound and doppler ultrasound obtained routinely to further confirm the diagnosis of testicular atrophy.
Short term follow up performed at (3, 6 and 9 months) post procedure to assess the viability, size and site of testis by ultrasound and doppler to be compared with size of testis taken during operation.
We found that; Regarding age of 50 non palpable testicle; the mean age of all patients was (3.9 ± 1.8) years.
Regarding Testicular volume (baseline) was (0.57 ± 0.07) ml.
• The 50 non-palpable undescended testes were classified according to surgical procedure into 2 independent groups: group A (1-stage) (25 Impalpable testiss) and group B (2-stage) (25 Impalpable testis).
Comparative study between the 2 groups revealed the following:
• Non-significant difference as regards Age (p > 0.05).
• Non-significant difference as regards Testicular volume (baseline) (p > 0.05).
• Statistical Significant decrease in Operative time, and LOS in group A (1-stage); compared to group B (2-stage) (p < 0.05 respectively).
• Non-significant difference as regards post-operative testicular volume (both techniques were effective) (p > 0.05).
• Non-significant difference as regards Final post-operative outcomes (testicular atrophy and success rate) (both techniques were effective) (p > 0.05).
Conclusion: To conclude, Laparoscopy provides a safe and effective method for managing children with nonpalpable testes, but one-stage laparoscopic orchidopexy with preservation of guberuculum and ligation of testicular vessels to be as effective as two-stage laparoscopic Fowler–Stephens’s orchidopexy with preservation of guberuculum, and this will minimize the risk of anesthesia for one time, reduce hospital stay with its hazards, save the hospital resources and relieves pressure on the psyche of the child.