Raashid Hamid, Akshit Sudanshu, Mir Fahiem-Ul-Hassan, Ubayer Nabi, Waseem Jan Shah, Nisar A Bhat, Ajaz A Baba, Gowhar Nazir Mufti, Idrees Bashir, Fayaz Ahmad
{"title":"儿科患者开放与腹腔镜II期Fowler-Stephens兰花切除术的前瞻性比较研究。","authors":"Raashid Hamid, Akshit Sudanshu, Mir Fahiem-Ul-Hassan, Ubayer Nabi, Waseem Jan Shah, Nisar A Bhat, Ajaz A Baba, Gowhar Nazir Mufti, Idrees Bashir, Fayaz Ahmad","doi":"10.1177/03915603241313025","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic Fowler Stephens orchidopexy, single stage or two-stage, is now routinely performed in non-palpable testis. We performed second stage orchidopexy as open inguinal approach and compared the outcome of this approach to two-staged laparoscopic orchidopexy.</p><p><strong>Methods: </strong>We performed a prospective randomized interventional study of two different approaches for intra-abdominal testis. In group A, Laparoscopic stage I (SFO) followed by open inguinal orchidopexy was compared for final outcome in group B cases, who underwent laparoscopic staged SF orchidopexy. The average duration between stage I SF and stage II SF was 6 months. All the procedures were done under GA and caudal analgesia. The pre-operative and post-operative USG dimensions were compared in cm and cm<sup>3</sup>/ml. The procedure outcome was considered successful if testis remained inside scrotum below mid-scrotal point. Any testis above the mid-scrotal point was considered as unacceptable or failure of procedure.</p><p><strong>Results: </strong>This study was performed on 74 children with 84 testis (group 'A' 38 patients (48 testis) and group 'B' 36 patients (46 testes)), with average age was 3.3 ± 0.46 and 3.9 ± 0.58 years, respectively. In group 'A', 38 patients (48 testes) underwent lap SFO I followed by inguinal orchidopexy and in group 'B', 36 patients (46 testes) underwent laparoscopic staged SF O. The mean testicular volume pre-operative in group 'A' & 'B' was 0.28 ± 0.04 and 0.23 ± 0.06 cm<sup>2</sup>, respectively. The mean post-operative testicular volume was 0.34 ± 0.07 and 0.28 ± 0.05 cm<sup>2</sup>, respectively. The average follow-up of the patients in group 'A' & 'B' was 24 ± 3.67 and 20 ± 2.90 months, respectively. Testis was having good volume in 87.5% and 76.60% of these successful cases, respectively. There were (3/48) 6.25% (4/46) 8.69% testicular atrophy cases in group 'A' & 'B', respectively. The differences were not statistically significant (<i>p</i> < 0.05). The mean operative time in group A was 20 ± 8.07 min and group B 30 ± 7.19 min in stage II procedure.</p><p><strong>Conclusion: </strong>The success rate in group A was more than the group B which was statistically significant (<i>p</i> > 0.05). Our study connotes that open stage II orchidopexy is still feasible and practicable with better final outcome of management of non-palpable cases.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603241313025"},"PeriodicalIF":0.8000,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A prospective comparative study of open versus laparoscopic stage II Fowler-Stephens orchidopexy in pediatric patients.\",\"authors\":\"Raashid Hamid, Akshit Sudanshu, Mir Fahiem-Ul-Hassan, Ubayer Nabi, Waseem Jan Shah, Nisar A Bhat, Ajaz A Baba, Gowhar Nazir Mufti, Idrees Bashir, Fayaz Ahmad\",\"doi\":\"10.1177/03915603241313025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Laparoscopic Fowler Stephens orchidopexy, single stage or two-stage, is now routinely performed in non-palpable testis. We performed second stage orchidopexy as open inguinal approach and compared the outcome of this approach to two-staged laparoscopic orchidopexy.</p><p><strong>Methods: </strong>We performed a prospective randomized interventional study of two different approaches for intra-abdominal testis. In group A, Laparoscopic stage I (SFO) followed by open inguinal orchidopexy was compared for final outcome in group B cases, who underwent laparoscopic staged SF orchidopexy. The average duration between stage I SF and stage II SF was 6 months. All the procedures were done under GA and caudal analgesia. The pre-operative and post-operative USG dimensions were compared in cm and cm<sup>3</sup>/ml. The procedure outcome was considered successful if testis remained inside scrotum below mid-scrotal point. Any testis above the mid-scrotal point was considered as unacceptable or failure of procedure.</p><p><strong>Results: </strong>This study was performed on 74 children with 84 testis (group 'A' 38 patients (48 testis) and group 'B' 36 patients (46 testes)), with average age was 3.3 ± 0.46 and 3.9 ± 0.58 years, respectively. In group 'A', 38 patients (48 testes) underwent lap SFO I followed by inguinal orchidopexy and in group 'B', 36 patients (46 testes) underwent laparoscopic staged SF O. The mean testicular volume pre-operative in group 'A' & 'B' was 0.28 ± 0.04 and 0.23 ± 0.06 cm<sup>2</sup>, respectively. The mean post-operative testicular volume was 0.34 ± 0.07 and 0.28 ± 0.05 cm<sup>2</sup>, respectively. The average follow-up of the patients in group 'A' & 'B' was 24 ± 3.67 and 20 ± 2.90 months, respectively. Testis was having good volume in 87.5% and 76.60% of these successful cases, respectively. There were (3/48) 6.25% (4/46) 8.69% testicular atrophy cases in group 'A' & 'B', respectively. The differences were not statistically significant (<i>p</i> < 0.05). The mean operative time in group A was 20 ± 8.07 min and group B 30 ± 7.19 min in stage II procedure.</p><p><strong>Conclusion: </strong>The success rate in group A was more than the group B which was statistically significant (<i>p</i> > 0.05). Our study connotes that open stage II orchidopexy is still feasible and practicable with better final outcome of management of non-palpable cases.</p>\",\"PeriodicalId\":23574,\"journal\":{\"name\":\"Urologia Journal\",\"volume\":\" \",\"pages\":\"3915603241313025\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-01-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urologia Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/03915603241313025\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/03915603241313025","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
A prospective comparative study of open versus laparoscopic stage II Fowler-Stephens orchidopexy in pediatric patients.
Introduction: Laparoscopic Fowler Stephens orchidopexy, single stage or two-stage, is now routinely performed in non-palpable testis. We performed second stage orchidopexy as open inguinal approach and compared the outcome of this approach to two-staged laparoscopic orchidopexy.
Methods: We performed a prospective randomized interventional study of two different approaches for intra-abdominal testis. In group A, Laparoscopic stage I (SFO) followed by open inguinal orchidopexy was compared for final outcome in group B cases, who underwent laparoscopic staged SF orchidopexy. The average duration between stage I SF and stage II SF was 6 months. All the procedures were done under GA and caudal analgesia. The pre-operative and post-operative USG dimensions were compared in cm and cm3/ml. The procedure outcome was considered successful if testis remained inside scrotum below mid-scrotal point. Any testis above the mid-scrotal point was considered as unacceptable or failure of procedure.
Results: This study was performed on 74 children with 84 testis (group 'A' 38 patients (48 testis) and group 'B' 36 patients (46 testes)), with average age was 3.3 ± 0.46 and 3.9 ± 0.58 years, respectively. In group 'A', 38 patients (48 testes) underwent lap SFO I followed by inguinal orchidopexy and in group 'B', 36 patients (46 testes) underwent laparoscopic staged SF O. The mean testicular volume pre-operative in group 'A' & 'B' was 0.28 ± 0.04 and 0.23 ± 0.06 cm2, respectively. The mean post-operative testicular volume was 0.34 ± 0.07 and 0.28 ± 0.05 cm2, respectively. The average follow-up of the patients in group 'A' & 'B' was 24 ± 3.67 and 20 ± 2.90 months, respectively. Testis was having good volume in 87.5% and 76.60% of these successful cases, respectively. There were (3/48) 6.25% (4/46) 8.69% testicular atrophy cases in group 'A' & 'B', respectively. The differences were not statistically significant (p < 0.05). The mean operative time in group A was 20 ± 8.07 min and group B 30 ± 7.19 min in stage II procedure.
Conclusion: The success rate in group A was more than the group B which was statistically significant (p > 0.05). Our study connotes that open stage II orchidopexy is still feasible and practicable with better final outcome of management of non-palpable cases.
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