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临床上,对于高位的腹腔型隐睾往往会采用Fowter-Stephens手术,其基本思路是切断精索对睾丸的牵拉,从而保证睾丸无张力地能顺利下降到阴囊。一般认为,Fowter-Stephens手术的成功率在70％左右[1]。精索血管切断以后睾丸的备液主要依靠并行的输精管血管供给,据报道此时的睾丸血流量将下降80％,而恢复正常需要近30天的时间[2]。采用显微技术血管吻合的方法进行自体睾丸移植可以提高手术成功率,有报道说经短期随访,手术成功率在83％到100％[3-6]。但手术时睾丸的平均缺血时间在1.6小时左右[6]。缺血时间的长短直接关系到睾丸的存活。研究表明,45分钟的缺血会导致睾丸的中度损伤,生殖上皮遭受可逆的破坏,缺血时间延长到120分钟,睾丸会受到广泛、严重,甚至是无法恢复的损伤[10]。
Clinically, high peritoneal cryptorchidism often use Fowter-Stephens surgery, the basic idea is to cut off the spermatic cord traction on the testis, so as to ensure that the testicles without tension can be successfully dropped to the scrotum. It is generally believed that the success rate of Fowter-Stephens surgery is about 70% [1]. Testis fluid preparation after stenotic sever mainly depends on the vas deferens supply in parallel. It is reported that the testicular blood flow will decrease by 80% at this time, and it takes nearly 30 days to recover normally [2]. The use of microsurgical vascular anastomosis for autologous testicular transplantation can improve the success rate of surgery, there are reports that short-term follow-up, the success rate of 83% to 100% of surgery [3-6]. However, the average duration of testicular ischemia during 1.6 hours [6]. The length of the ischemic time is directly related to testicular survival. Studies have shown that 45 minutes of ischemia can lead to moderate damage to the testis, reversible damage to the reproductive epithelium, extending the ischemic time to 120 minutes, the testicles will be extensive, serious, or even irreparable damage [10].