论文部分内容阅读
目的结合1例睾丸横过异位患者的诊治过程,复习有关文献探讨其病因学、诊断方法和治疗措施。方法本院收治1例青年男性患者存在左侧睾丸横过异位伴同侧精索鞘膜积液,右侧腹股沟斜疝,右侧附睾囊肿,手术证实右侧腹股沟2根输精管和2根精索,右侧阴囊内2个睾丸。将异位的左侧睾丸通过阴囊纵隔复位固定于对侧阴囊肉膜下,并行左侧精索鞘膜大部切除,右侧腹股沟疝修补术,右侧附睾囊肿切除术。根据该患者的临床表现、诊断和治疗过程,结合相关文献对该病的整体临床特征进行分析。结果本例患者术后诊断为:①左侧睾丸横过异位;②左侧精索鞘膜积液;③右侧腹股沟复发疝;④右侧附睾囊肿;⑤弱精症。术后患者病情恢复顺利,术后随访3个月,复查见患者双侧睾丸位置良好,形态大小和血供正常。其他伴随异常均消失。结论睾丸横过异位作为一种罕见的生殖系发育畸形,常伴有腹股沟疝、精索鞘膜积液甚至苗勒氏管持续存在综合征等多种异常,宜及早采取手术治疗并同时纠正伴随病变。为避免伴随的胚胎发育残迹的远期癌变,术后需长期随访。
Objective To review the literature about the etiology, diagnosis and treatment of one case of testicular transverse ectopic diagnosis and treatment. Methods One case of young men admitted to our hospital had left testes across the ectopic with ipsilateral spermatic cord effusion, right inguinal hernia, right epididymal cyst. Surgical confirmation of the right inguinal 2 vas deferens and 2 spermatic cord , 2 testicles in the right scrotum. The ectopic left testis through the scrotum mediastinal reduction and fixation in the contralateral scrotum submucosal parallel paraplegia mass left lateral resection of the right inguinal hernia repair epididymal cyst excision. According to the patient’s clinical manifestations, diagnosis and treatment process, combined with the relevant literature on the overall clinical features of the disease were analyzed. Results The patients were diagnosed postoperatively as: ① left testicular transverse ectopic; ② left spermatic cord effusion; ③ right inguinal hernia recurrence; ④ right epididymal cyst; ⑤ asthenopia. Postoperative patients recovered well, after 3 months of follow-up, review showed good bilateral testicular position, size and blood supply to normal. Other accompanying anomalies disappeared. Conclusion Testes cross the ectopic as a rare genital developmental deformity, often accompanied by inguinal hernia, spermatic cord effusion and even Mullerian canal persistence syndrome and other abnormalities, surgical treatment should be taken as soon as possible and at the same time to correct With the disease. Long-term follow-up is required after surgery to avoid future cancers associated with the developmental remnants of the embryo.