Open Versus Laparoscopic Gubernaculum-Sparing Second-Stage Fowler–Stephens Orchiopexy for Intra-Abdominal Testis: A Long-Term Study

作者：Guanglun Zhou, Jinjun Chen, Jianchun Yin, Xiaodong Liu, Jiahong Su, Shoulin Li · 发表于：Journal of Laparoendoscopic & Advanced Surgical Techniques · 年份：2022 · DOI：10.1089/lap.2021.0843 · 被引用次数：5 · 研究领域：Testicular diseases and treatments、Sexual Differentiation and Disorders、Urologic and reproductive health conditions

Background: The benefits of performing open versus laparoscopic gubernaculum-sparing second-stage Fowler–Stephens orchiopexy (FSO) remain unclear. We compared the two techniques to answer this question. Methods: We retrospectively studied a cohort of patients who underwent laparoscopic first-stage FSO and open versus laparoscopic gubernaculum-sparing second-stage FSO at our institution between September 2004 and June 2020 (all patients underwent surgery by a single surgeon). We evaluated both procedures based on the incidence of testicular atrophy, testicular ascent, and other complications. Results: The age at initial surgery was 45.7 ± 28.2 months (median, 39). One hundred nine cases were treated with open second-stage gubernaculum-sparing FSO (OFSO), and 96 cases were treated with laparoscopic second-stage gubernaculum-sparing FSO (LFSO). The mean follow-up period was 59.8 months (median, 54; standard deviation, +35). The overall testicular atrophy rate was 1.5%. Atrophy was observed in 2 and 1 patient in the OFSO and LFSO groups, respectively (1.8% versus 1.0%, P > .05). There was no significant difference in the incidence of testicular ascent between both groups (2.8% versus 3.1%). Five and four complications were noted in the OFSO and LFSO groups, respectively ( P > .05). Conclusions: Second-stage gubernaculum-sparing FSO achieved high testicular survival rates and satisfactory testicular positions. Neither the open nor laparoscopic approach appeared superior, bec...