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目的研究睾丸离断再植方法。方法从1998～2005年收治4例睾丸完全离断,阴囊伤口严重污染,精索近端撕脱平面高于腹股沟外环口的复杂性损伤。先将睾丸远位寄生在同侧腹部皮下,血管与腹壁浅动静脉或旋髂浅动静脉吻合,寄生成活,阴囊伤口清创后旷置延迟缝合。二期将睾丸转位纳入阴囊并吻合输精管,伴阴囊缺损同时作阴囊成形术。结果 4例全部成活。随访5～10年,第二性征无明显变化,阴茎勃起正常,触摸睾丸柔软度与对侧无差别,血浆睾丸酮、LH、FSH均为正常值。结婚后均有子女。结论寄生再植采用分期手术的方法,阴囊伤口延迟缝合,二期行睾丸转位回植,阴囊成形,为复杂性睾丸离断再植提供一种新的尝试。
Objective To study the methods of testicular replantation. Methods From 1998 to 2005, 4 cases of testis were severed completely, the scrotal wound was seriously polluted, and the proximal avulsion plane of the spermatic cord was higher than that of the groin. Testicular distal parasites in the ipsilateral abdomen first subcutaneous, vascular and abdominal shallow veins or iliac artery superficial vein anastomosis, parasitic survival, scrotal wound delamination delamination delayed suture. The second phase of testicular transposition into the scrotum and anastomosis vas deferens, scrotum defect with scrotoplasty at the same time. Results 4 cases all survived. Followed up for 5 to 10 years, no significant changes in the second sexual characteristics, normal penile erection, soft touch and no difference between the opposite side, plasma testosterone, LH, FSH are normal. Have children after marriage. Conclusion The method of staging surgery, delayed suture of scrotal wound, replanted testis and secondary scrotum in the second stage of parasitological replantation provide a new attempt for replantation of complex testes.