丸回归综合征再审:从一个15年的回顾性研究的见解和管理的不断变化的观点
Celine Sarah Thomas1, Lianne Dmello1, Tarun John K Jacob1
1Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, 632004, India.
Journal of pediatric urology
|February 26, 2026
概括
丸回归综合征 (TRS) 遗留物很少含有活性的生殖细胞 (GCs),没有报告的恶性瘤. 建议在腹内残留物时进行切除,但选择性管理可能适合 inguino-scrotal 病例.
科学领域:
- 儿科手术 儿科手术
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 发育生物学 发展生物学
背景情况:
- 丸回归综合征 (TRS) 是一种丸组织缺失,但带结构仍然存在的密码化形式.
- 由于担心来自精管 (SNT) 或生殖细胞 (GC) 的恶性潜力,常规切除TRS残留物是常见的,尽管这种风险仍在争论中.
研究的目的:
- 为了评估从临床上无法触摸丸的儿童的丸残留物中发生的组织病理学发现.
- 确定TRS残留物中SNTs和GCs的发生率,并评估恶性瘤的风险因素.
主要方法:
- 追溯对262名丸无法触摸的儿童进行诊断性腹腔镜或 inguinal 探索 (2008-2022) 的回顾.
- 对切除的丸残留物进行详细的组织病理学检查,以寻找SNT,GC和回归特征.
主要成果:
- 在10.3%的残留物中发现了SNT,只有1.1%的可行的GC.
- 在腹腔内残留物中,SNT/GC的发生率 (62%) 与 inguinal (10%) 或 scrotal (4%) 残留物相比显著更高 (p < 0.0001).
- 在任何残留物中都没有报告侵入性恶性瘤.
结论:
- TRS残留物很少含有可活的GC,侵入性恶性瘤并不是一个显著的风险.
- 建议切除腹内残留物,同时可以考虑选择性管理 inguino-scrotal 残留物.
- 需要进一步的前性研究来制定基于证据的TRS管理指南.
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