Malignancy in the Cryptorchid Testis

Martin, Donald C.

doi:10.1016/s0094-0143(21)01351-3

Cited by 66 publications

(1 citation statement)

References 21 publications

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“…[ 3 ] The disadvantage of the two-stage approach is the need for two procedures many months apart. [ 4 5 ] Developing a uniform surgical approach that can achieve equal success rates for all cases, regardless of testicular position, is ideal. We describe a surgical modification based on the one-stage LFSO.…”

Section: Introductionmentioning

confidence: 99%

Standardized single-stage laparoscopic Fowler-Stephens orchiopexy regardless of testis position

Neheman

Shumaker

Grazi

et al. 2022

Journal of Minimal Access Surgery

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Background/Purpose: It is generally perceived that a primary laparoscopic orchiopexy has superior outcomes due to preservation of the testicular artery, and thus should be the choice when achievable. The two-stage laparoscopic Fowler-Stephens orchiopexy (LFSO) is considered superior regarding success rate compared to the one-stage procedure when the artery must be transected. Outcomes can be jeopardized when a primary orchiopexy is ultimately realized to be the incorrect procedure due to insufficient testicular artery length. It is preferable to decide the approach before initiating dissection, however, in reality, this does not always occur. Purpose: It is generally perceived that a primary laparoscopic orchiopexy has superior outcomes due to preservation of the testicular artery, and thus should be the choice when achievable. The two-stage laparoscopic Fowler-Stephens orchiopexy (LFSO) is considered superior regarding success rate compared to the one-stage procedure when the artery must be transected. Outcomes can be jeopardized when a primary orchiopexy is ultimately realized to be the incorrect procedure due to insufficient testicular artery length. It is preferable to decide the approach before initiating dissection, however, in reality, this does not always occur. Materials and Methods: Key surgical maneuvers implicated in the modified one-stage LFSO (M-LFSO) include preservation of a wide peritoneal flap between the vessels and the vas deferens, dissecting the vessels as proximal as possible and avoiding manipulation of the epididymis and vessels between the vas and epididymis when transferring the testis to the scrotum. Results: Our cohort included 55 boys (59 testes). Median age and weight at surgery were 13.3 months (interquartile range [IQR] 9.2–32.4) and 10.4 kg (IQR 9.2–12.6). The mean operative time was 70 min (IQR 60–85). The median follow-up was 11 months (IQR 7–12). There was one case of testicular atrophy (2%) and two cases of suboptimal testicular position in the scrotum at 6 months. Conclusions: M-LFSO is a standardized approach for all cases of IAT regardless of testicular position. Preservation of a wide peritoneal flap and proximal dissection of the vessels may contribute to the adequate testicular blood supply. The proposed approach eliminates the need for intra-operative decision-making and for ancillary procedures.

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Section: Introductionmentioning

confidence: 99%

Standardized single-stage laparoscopic Fowler-Stephens orchiopexy regardless of testis position

Neheman

Shumaker

Grazi

et al. 2022

Journal of Minimal Access Surgery

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Acquired Undescended Testes

Schiffer¹,

Kogan²,

Reda³

et al. 1987

Arch Pediatr Adolesc Med

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Germ cell testis cancer: 15-year review

et al. 1996

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Testis cancer affects 2–3 men per every 100,000 in the United States, making it the most common solid tumor of men in the 20–35‐year‐old age range. Since the average age of active duty military personnel is included in the age range of those at greatest risk for germ cell testis cancer, it is of pertinent clinical importance to physicians who treat these young patients. The National Naval Medical Center has been using cisplatin‐based protocols since the time of their introduction. This study reviews the success of treating these patients and examines the treatment failures. © 1996 Wiley‐Liss, Inc.

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Malignancy in the Cryptorchid Testis

Cited by 66 publications

References 21 publications

Standardized single-stage laparoscopic Fowler-Stephens orchiopexy regardless of testis position

Standardized single-stage laparoscopic Fowler-Stephens orchiopexy regardless of testis position

Acquired Undescended Testes

Germ cell testis cancer: 15-year review

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