The Application of Scrotoscope-Assisted Minimally Invasive Excision for Epididymal Mass: An Initial Report.

Chuying Qin,Liefu Ye,Tao Li,Yunliang Gao,Ruochen Zhang,Jinrui Yang,Yaojin Yang,Yongbao Wei,Wanghai Cai,Qingguo Zhu

doi:10.3389/fsurg.2022.804803

Abstract

BackgroundTo compare the middle-term efficacy and safety results between scrotoscope-assisted (SA) minimally invasive excision and traditional open excision (OE) for the treatment of epididymal mass.MethodsA total of 253 males with surgery excision of epididymal mass from 2012 to 2018 were included in this retrospective study. Patients were divided into two groups: the traditional OE group and the SA group. Patient demographics and intraoperative and postoperative outcomes were obtained and compared between these two groups.ResultsAbout 174 patients (68.8%) underwent SA, and the other 79 (31.2%) underwent OE. Demographic data were similar between the two groups. Compared with OE surgery, SA could significantly shorten the operating time (19.4 ± 4.1 vs. 53.8 ± 12.9 min), reduce blood loss (5.3 ± 1.5 vs. 21.3 ± 5.6 ml), and downsize the operative incision (1.5 ± 0.3 vs. 4.5 ± 0.8 cm). Additionally, postoperative complications were significantly less occurred in the SA group than those in OE (15.5% vs. 21.5%), in particular scrotal hematoma (1.7% vs. 12.7%) and incision discomfort (2.8% vs. 6.3%). Patients in the SA group had a significantly higher overall satisfaction score (94.8 ± 3.7 vs. 91.7 ± 4.9) and a significantly shorter length of hospital stay (4.1 ± 0.9 vs. 5.0 ± 1.5 days) than those in the OE group. No postoperative testicular atrophy occurred in the SA group.ConclusionSA is emerging as a novel and effective option with promising perspectives for epididymal mass therapy.

Highlights

Epididymal mass is recognized as a common disorder in the male population but still seems to be a diagnostic and therapeutic dilemma
Postoperative complications were significantly less occurred in the SA group than those in open excision (OE) (15.5% vs. 21.5%), in particular scrotal hematoma (1.7% vs. 12.7%) and incision discomfort (2.8% vs. 6.3%)
A total of 253 patients with epididymal masses were enrolled in this retrospective study, 174 underwent SA and 79 underwent OE

Summary

Introduction

Epididymal mass is recognized as a common disorder in the male population but still seems to be a diagnostic and therapeutic dilemma. The most prominent types of epididymal mass are mass-forming epididymitis [1, 2], epididymal cyst [3], epididymal sperm granuloma [4, 5], epididymal tuberculosis, and so on. Primary tumors of the epididymis origin are rarely occurred, accounting for about 2.5% of male genital tumors [6] and at most 0.03% of all male cancers [7]. Adenomatoid tumor is the most common type of epididymal tumors. Epididymal masses are almost always benign without specific treatments. When an epididymal mass is a suspected malignant tumor or does not benefit from conservative treatments, surgical interventions appear to be considered [8– 10]. To compare the middle-term efficacy and safety results between scrotoscope-assisted (SA) minimally invasive excision and traditional open excision (OE) for the treatment of epididymal mass

Methods

Results

Conclusion