• 廣西醫(yī)科大學(xué)第四附屬醫(yī)院普外科（廣西柳州，545005）;

目的 　研究完全腹膜外腹腔鏡腹股溝疝修補(bǔ)術(shù)對睪丸血流灌注及體積的影響。 方法 　2009年7月－2011年5月，對62例行完全腹膜外腹腔鏡單側(cè)腹股溝疝修補(bǔ)術(shù)男性患者進(jìn)行自身前后對照研究，比較術(shù)前、術(shù)后患側(cè)睪丸的睪丸動脈（TA）、睪丸包膜動脈（CA）、睪丸內(nèi)動脈（ITA）血流參數(shù)[收縮期峰值血流速度（PSV）、舒張未期血流速度（EDV）及血管阻力指數(shù)（RI）]、睪丸體積（TV）及血清睪酮的變化情況。 結(jié)果　 患者獲隨訪7～24個月，平均15.6個月，無復(fù)發(fā)患者。術(shù)前及術(shù)后3、6個月時患側(cè)TV分別為（9.91 ± 3.72）、（10.23 ± 4.18）和（10.16 ± 3.94）cm3，同期血漿睪酮水平分別為（544.25 ± 123.72）、（532.89 ± 145.66）和（565.65 ± 138.13）μg/L，手術(shù)前后比較患側(cè)TV（F=1.350，P=0.263）、血漿睪酮水平（F=1.673，P=0.192）無統(tǒng)計學(xué)意義，血漿睪酮水平均在正常范圍內(nèi)。術(shù)后3、6個月患側(cè)TA、CA和ITA的EDV明顯高于術(shù)前，RI較術(shù)前明顯降低，差異均有統(tǒng)計學(xué)意義（P＜0.05）；PSV與術(shù)前比較差異無統(tǒng)計學(xué)意義（P＞0.05）。術(shù)后3個月患側(cè)睪丸各動脈PSV、EDV、RI與術(shù)后6個月比較差異無統(tǒng)計學(xué)意義（P＞0.05）。 結(jié)論　 完全腹膜外腹腔鏡腹股溝疝修補(bǔ)術(shù)后患側(cè)睪丸血流灌注情況可能會有所改善，不影響TV及血清睪酮水平。

引用本文： 宋學(xué)民,黃世鋒. 完全腹膜外腹腔鏡腹股溝疝修補(bǔ)術(shù)對睪丸血流灌注及體積的影響. 華西醫(yī)學(xué), 2012, 27(7): 1011-1014. doi: 復(fù)制

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9. 　Koksal N, Altinli E, Sumer A, et al. Impact of herniorraphy technique on testicular perfusion: results of a prospective study[J]. Surg Laparosc Endosc Percutan Tech, 2010, 20(3): 186-189.
10. 　Mihmanli I, Kantarci F, Kulaksizoglu H, et al. Testicular size and vascular resistance before and after hydrocelectomy[J]. AJR Am J Roentgenol, 2004, 183(5): 1379-1385.
11. 　Turgut AT, Unsal A, Ozden E, et al. Unilateral idiopathic hydrocele has a substantial effect on the ipsilateral testiculargeometry and resistivity indices[J]. J Ultrasound Med, 2006, 25(7): 837-843.
12. 　Orth RC, Towbin AJ. Acute testicular ischemia caused by incarcerated inguinal hernia[J]. Pediatr Radiol, 2012, 42(2): 196-200.
13. 　Waseem M, Pinkert H, Devas G. Testicular infarction becoming apparent after hernia reduction[J]. J Emerg Med, 2010, 38(4): 460-462.
14. 　Akbulut G, Serteser M, Yücel A, et al. Can laparoscopic hernia repair alter function and volume of testis? Randomized clinical trial[J]. Surg Laparosc Endosc Percutan Tech, 2003, 13(6): 377-381.
15. 　Schier F, Turial S, Hückstädt T, et al. Laparoscopic inguinal hernia repair does not impair testicular perfusion [J]. J Pediatr Surg, 2008, 43(1): 131-125.
  1. 1. 　McKernan JB, Laws HL. Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach[J]. Surg Endosc, 1993, 7(1): 26-28.
  2. 2. 　Singh AN, Bansal VK, Misra MC, et al. Testicular functions， chronic groin pain， and quality of life after laparoscopic and open mesh repair of inguinal hernia: a prospective randomized controlled trial[J]. Surg Endosc, 2012, 26(5): 1304-1317.
  3. 3. 　李建文, 張云.腹腔鏡和開放式腹股溝疝修補(bǔ)術(shù)的合理選擇[J].腹腔鏡外科雜志, 2011, 16(1): 6-9.
  4. 4. 　Sucullu I， Filiz AI， Sen B， et al. The effects of inguinal hernia repair on testicular function in young adults: a prospective randomized study[J]. Hernia, 2010, 14(2): 165-169.
  5. 5. 　韓振藩, 師其智.男性生殖系外科[M].北京:人民衛(wèi)生出版社, 1989: 34-35.
  6. 6. 　Koksal N, Altinli E, Sumer A, et al. Impact of herniorraphy technique on testicular perfusion: results of a prospective study[J]. Surg Laparosc Endosc Percutan Tech, 2010, 20(3): 186-189.
  7. 7. 　Celik AS, Memmi N, Celebi F, et al. Impact of slit and nonslit mesh technique on testicular perfusion and volume in the early and late postoperative period of the totally extraperitoneal preperitoneal technique in patients with inguinal hernia[J]. Am J Surg, 2009, 198(2): 287-291.
  8. 8. 　Tarhan S, Ucer O, Sahin MO，et al. Long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow[J]. J Androl, 2011, 32(1): 33-39.
  9. 9. 　Koksal N, Altinli E, Sumer A, et al. Impact of herniorraphy technique on testicular perfusion: results of a prospective study[J]. Surg Laparosc Endosc Percutan Tech, 2010, 20(3): 186-189.
  10. 10. 　Mihmanli I, Kantarci F, Kulaksizoglu H, et al. Testicular size and vascular resistance before and after hydrocelectomy[J]. AJR Am J Roentgenol, 2004, 183(5): 1379-1385.
  11. 11. 　Turgut AT, Unsal A, Ozden E, et al. Unilateral idiopathic hydrocele has a substantial effect on the ipsilateral testiculargeometry and resistivity indices[J]. J Ultrasound Med, 2006, 25(7): 837-843.
  12. 12. 　Orth RC, Towbin AJ. Acute testicular ischemia caused by incarcerated inguinal hernia[J]. Pediatr Radiol, 2012, 42(2): 196-200.
  13. 13. 　Waseem M, Pinkert H, Devas G. Testicular infarction becoming apparent after hernia reduction[J]. J Emerg Med, 2010, 38(4): 460-462.
  14. 14. 　Akbulut G, Serteser M, Yücel A, et al. Can laparoscopic hernia repair alter function and volume of testis? Randomized clinical trial[J]. Surg Laparosc Endosc Percutan Tech, 2003, 13(6): 377-381.
  15. 15. 　Schier F, Turial S, Hückstädt T, et al. Laparoscopic inguinal hernia repair does not impair testicular perfusion [J]. J Pediatr Surg, 2008, 43(1): 131-125.