Gallardo MAF, González SJM, Espinosa JH, Vázquez JH

Language: Spanish
References: 11
Page: 80-85
PDF size: 149.41 Kb.

ABSTRACT

Introduction: Cryptorchidism, has a prevalence of 1-2% in the general population. Of these 20% are non palpable or intra-abdominal testes, and the rest are canalicular testes. In 1992 Jordan et al., Introduced laparoscopy as a diagnostic method in patients with non-palpable testis . And it is now the treatment of choice in the management of intra-abdominal testes. In 1995 Docimo et al applied the laparoscopic technique for canalicular testes (palpable). Riquelme et al., In 2009, and Escárcega et al. in 2011, published laparoscopic orchidopexy for canalicular testes (palpable), with 100% succes rate.
Material and Methods: 33 patients were studied all underwent laparoscopic orchiopexy. The surgical technique is described extensively.
Results: 10 orchidopexies were bilateral (20 units) and 23 unilateral (11 right and 12 left), giving a total of 43 operated testes. Of those, 14 were intraabdominal and 29 canalicular. The age range was as follows: 2 patients younger than 5 years, 15 between 1-3, 4 between 3-5 years, 10 between 5-10 years, and 2 over 10 years. Monitoring of the 33 patients (43 testicular units operated), ranging from 6 months to 5 years (average 13 months). The position and size of the testis according to the classification of Beltran Brown, was as follows: Of the 29 canalicular 26 were A, 1 B and 2 size C. Of the 14 abdominal, 4 were size A; 2 B, and 3 C. In 5 cases had orchiectomy because the testis was completely atrophic in the abdominal cavity. The first cases consumed 60 minutes of surgical time for unilateral testicular and about 90 minutes. for bilateral. In the latter cases, the time was reduced to 35-40 minutes for 50-60 minutes for unilateral and bilateral.
Conclusions: We believe that laparoscopic orchidopexy is the method of choice for cryptorchidism, not only but also for intraabdominal but also for canalicular, according to the results presented.

REFERENCES

1. 1.- Berkowitz GS, Lapinsky RH, Dolgin SE et al. Prevalence and natural History of cryptorchidism. Pediatr 1993; 92:44-49.

2. 2.- Nieto. J., Ordorica RM. Orquidopexia laparoscópica en testículo no descendido de localización intra-abdominal. Asociación Mexicana de Cirugía Endoscópica A.C.,2001 Vol. 2 (4) Oct-dic: 181-184.

3. - Cortesi N, Ferrari P., Zambarda E., et al., Diagnosis of bilateral abdominal criptorchidism by laparoscopic. Endsocopy 1976;8:33-34.

4. 4.- Jordna GH, Robey EL, Winslow BH. Laparoscopic Surgical management of the abdominal/transinguinal undescended testicle. J Endourolo 1992; 6;159-0.

5. 5.- Docimo SG, Moore RG, Adams J, Kavoussi LR. Laparoscopic Orchiopexy for the high palpable undescended testis; preliminary experience. J Urolo 1995;154 (4):1513-5.

6. 6.- Riquelme MA, Landa S, Gómez M., Meneses H, Andraca R. Orquidopexia laparoscópica en el testículo no descendido, palpable y no palpable. Rev Mex Urolo 2009; 69(5):215-218.

7. 7.- Frieland GW, Chang P. The role of imaging in the management of the impalpable undescnded testis. AJVR 1998; 151: 1107-1111.

8. 8.- Hamidina A, Nold S, Amanwah KS. Localisation of non-palpable testes. Surg Gyncol Obstet 1984; 159:439-0.

9. 9.- Tejedor R, López M, Cano A, García D et al. Indicciones, Técnica y resultados de la Orquidopexia laparoscópica en un solo tiempo. Cir Pediatr 2008;191-194.

10. 10 Bloom DA, Two step orchiopexy with pelvioscopic clip ligation of the spermatic vessels. J Urol 1991; 145;1030.

11. 11.- Escárcega P., Hernández G., Huerta E., Lezama N., Hernández S., et al. Orchiopexy laparoscopic or Traditional Surgical Technique in Patients with an Undescended Palpable Testicle. Journal of laparoscopic and advanced surgical techniques 2011; 21(2):185-187.