Abstract:Objective: To investigate the effect and safety of laparoscopic Bianchi operation in the treatment of inguinal cryptorchidism in children. Methods: Totally 120 children with cryptorchidism in inguinal area admitted to our hospital from June 2019 to June 2022 were selected as the research subjects.They were randomly divided into study group and control group,with 60 cases in each group.The study group was treated with Bianchi operation under laparoscope,and the control group was treated with a small testicular descending transverse inguinal incision.The operation indexes,serum sex hormones,interleukin-6 (IL-6),IL-8 The changes of high sensitivity C-reactive protein (hs CRP),serum anti Mullerian hormone (AMH),inhibin B (INHB) levels and the occurrence of surgical complications. Results: The average operation time of the study group was longer than that of the control group,and the amount of intraoperative bleeding,incision length,and hospital stay were all smaller than those of the control group,with significant differences (P<0.05).Before operation,there was no significant difference in the baseline serum T,E2,FSH,AMH,INHB levels between the study group and the control group (P>0.05).Three months after operation,the above serum hormone indexes were checked again.The serum AMH,INHB levels in the two groups were significantly higher than those before operation,and the serum E2,FSH levels were significantly lower than those before operation,with statistically significant differences (P<0.05).There was no significant difference in the above indicators between the two groups 3 months after operation (P>0.05).Before operation,there was no significant difference in the baseline serum IL-6,IL-8,hs CRP levels between the study group and the control group (P>0.05).On the first day after operation,the serum IL-6,IL-8 and hs CRP in the study group were lower than those in the control group,with significant differences (P<0.05).The measured values of IL-6,IL-8 and hs CRP in the two groups on the first day after operation were significantly higher than those before operation (P<0.05).The incidence of complications in the study group was 8.33%,which was lower than that in the control group (28.33%,P<0.05). Conclusion: The effect of Bianchi operation under laparoscope in the treatment of children with inguinal cryptorchidism is positive,with few complications,which is worthy of clinical application.
[1] Elamo HP,Virtanen HE,Toppari J.Genetics of cryptorchidism and testicular regression[J].Best Pract Res Clin Endocrinol Metab,2022,36(1):101619. [2] Mitsui T.Effects of the prenatal environment on cryptorchidism:a narrative review[J].Int Urol,2021,28(9):882-889. [3] Batra NV,DeMarco RT,Bayne CE.A narrative review of the history and evidence-base for the timing of orchidopexy for cryptorchidism[J].Pediatr Urol,2021,17(2):239-245. [4] Arredondo Montero J,Ayuso Gonzalez L,Hernandez-Martin S,et al.Cryptorchidism and spermatic pathway complete dissociation[J].ANZ Surg,2022,92(5):1273-1274. [5] Anand S,Krishnan N,Pogorelic Z.Utility of laparoscopic approach of orchiopexy for palpable cryptorchidism:a systematic review and meta-analysis.[J] Children (Basel),2021,8(8):677-680. [6] 诸福棠.实用儿科学[M].人民卫生出版社,1985. [7] 亚森江·阿布都拉,和军,玉苏甫·阿克木,等.血清抗苗勒管激素和血清抑制素B水平对隐睾症患者睾丸功能评价的意义[J].国际泌尿系统杂志,2021,41(2):336-340. [8] Moal J L,Goria S,Guillet A,et al.Time and spatial trends of operated cryptorchidism in France and environmental hypotheses:a nationwide study from 2002 to 2014[J].Human Reproduction,2021,36(5):1383-1394. [9] D'Oro A,Rosoklija I,Yerkes E B,et al.Proximal hypospadias and acquired cryptorchidism:incidence,morphology,and potential clinical implications[J].The Journal of Urology,2021,206(5):1291-1299. [10] Shiraishi K,Takihara H,Matsuyama H.Testicular temperature and the effects of orchiopexy in infants with cryptorchidism[J].Urol,2021,206(4):1031-1037. [11] 向东洲,王康太,张弢,等.腹腔镜结合Bianchi手术治疗低位隐睾[J].中国微创外科杂志,2022,22(1):55-58.