[Randomized controlled trial on the clinical efficacy of hernia needle combined with single port laparoscopic scrotal approach and testicular arch fixation for the treatment of middle and low cryptorchidism in children].

OBJECTIVE

To explore the clinical effect of hernia needle combined with single-port laparoscopy-assisted transscrotal orchidopexy (HN-SLATO) in the treatment of mid-low cryptorchidism in children.

METHODS

We selected 80 children with mid-low congenital cryptorchidism treated from January 2023 to January 2024, and equally randomized them into an observation and a control group to receive HN-SLATO and conventional laparoscopic orchidopexy (LO), respectively. We recorded the surgical parameters, the postoperative scores of the patients' on the Face-Legs-Activity-Crying-Consolability Scale (FLACC) and Vancouver Scar Scale (VSS), the serological indicators of interleukin-6 (IL-6), inhibitor B (INH-B) and high-sensitivity C-reactive protein (hsCRP), and the incidence of postoperative complications at 1 month after surgery between two groups, followed by comparison between the two groups.

RESULTS

The total effectiveness rate of treatment was significantly higher in the observation than in the control group (97.5% vs 75.0%, P<0.05), and so was the success rate of testicular descent (100% vs 85.0%, P<0.05), but there was no significant difference in surgical time and postoperative hospital stay between the two groups (P > 0.05). The VSS score was remarkably lower in the former than in the latter group (3.3 ± 0.9 vs 4.3 ± 1.0, P<0.05). The FLACC scores were markedly increased in both the observation and control groups at 24 hours (3.6 ± 0.2 and 4.1 ± 0.3) and 72 hours (3.0 ± 0.3 and 3.5 ± 0.2) compared with those at 2 hours after surgery (2.2 ± 0.2 and 2.3 ± 0.1) (P<0.05), but less increased in the former group than in the latter (P<0.05). The postoperative levels of IL-6, INH-B, and hsCRP were all significantly elevated compared with the baseline in both groups, but less significantly in IL-6 and hsCRP in the observation than in the control group (P<0.05). The incidence of postoperative complications was dramatically lower in the former group than in the latter (2.5% vs 20.0%, P<0.01).

CONCLUSION

HN-SLATO has a significant clinical efficiency and high safety in the treatment of mid-low cryptorchidism in children, which can effectively improve intraoperative fixation and postoperative aesthetics of the testis, as well as reduce pain, serum inflammatory indicators and postoperative complications.