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Skurðaðgerðir við launeista á Barnaspítala Hringsins 1970-1993

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Authors
Anna Gunnarsdóttir
Drífa Freysdóttir
Guðmundur Bjarnason
Þráinn Rósmundsson
Jónas Magnússon
Tómas Guðbjartsson
Issue Date
2003-02-01

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Other Titles
The results of surgical treatment for cryptorchidism at Landspitalinn, 1970-1993
Citation
Læknablaðið 2003, 89(2):119-23
Abstract
Objective: Cryptorchidism is a common congenital genito-urological anomali in males with increased risk of infertility and testicular cancer. In this retrospective study the results of operations for undescended testis at Landspitalinn University Hospital were reviewed with special emphasis on patients diagnosed with testicular cancer later in life. Material and methods: The study includes 593 males with undescended testis who were operated on between 1970 and 1993. Information was gathered from hospital records, including birth-weight, age at diagnosis and operation, localization of the testes and complications to surgery. Information on patients diagnosed with testicular cancer was aquired from the Icelandic Cancer Registry. Results: The average birth-weight was 3461 g, including 58 boys (10%) with low birth-weight (
Inngangur: Launeista er algengur meðfæddur galli hjá drengjum og eru helstu fylgikvillar ófrjósemi og krabbamein í eistum. Tilgangur þessarar rannsóknar var annars vegar að kanna árangur aðgerða vegna launeista og hins vegar hverjir sjúklinganna hafa greinst með krabbamein í eistum. Efniviður og aðferðir: Rannsóknin var afturvirk og náði til 593 sjúklinga sem greindust með launeista eða gengust undir launeistaaðgerð á Barnaspítala Hringsins á tímabilinu 1. janúar 1970 til 31. desember 1993. Upplýsingar fengust úr sjúkraskrám, meðal annars um fæðingarþyngd, aldur við greiningu og aðgerð, staðsetningu eistans og fylgikvilla við aðgerðina. Með upplýsingum úr krabbameinsskrá Krabbameinsfélags Íslands var athugað hverjir þessara sjúklinga höfðu greinst með eistnakrabbamein fram til 31. desember 2000. Niðurstöður: Meðalfæðingarþyngd var 3461 g, þar af 58 drengir (10%) með fæðingarþyngd 2500 g. Meðalaldur við greiningu var 3,0 ár (bil 0-14 ár) og við aðgerð 7,5 ár (bil 0-51 ár). Launeista var algengara hægra megin (61%) (p<0,01) en 18% drengjanna voru með launeista beggja vegna. Við aðgerð var eistað í náragangi í 50% tilvika, í kviðarholi hjá 10% sjúklinga og í 34% tilvika utan leiðar (ectopic). Fylgikvillar sáust eftir 29 aðgerðir (5%) þar sem blóðgúll (2,7%) og skurðsýking (1,2%) voru algengastar. Rúmur helmingur (52%) drengjanna reyndist einnig hafa nárakviðslit. Af þessum 593 sjúklingum hafa tveir greinst með krabbamein í eistum, báðir með fósturvísiskrabbamein, 13 og 14 árum eftir launeistaaðgerð. Ályktanir: Árangur launeistaaðgerða er góður í þessari rannsókn. Greiningaraldur er tiltölulega hár (3,0 ár) en fer lækkandi. Aðgerðaraldur er sömuleiðis hár (7,5 ár) og töf á meðferð (4,5 ár) er óþarflega löng. Í þessari rannsókn var hlutfall þeirra sem greindust með eistnakrabbamein mjög lágt, eða 0,3%. Upplýsingar um ófrjósemi liggja ekki fyrir í þessari rannsókn.
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