Rajarajan, Pon A (2008) Pericardiectomy for Constrictive Pericarditis: A Comparative study between Total and Subtotal Pericardiectomy by Left Anterolateral Thoracotomy. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Cryptorchidism contributes the most common genital problem, and one of the most common overall problem encountered in pediatric surgical practice. Cryptorchidism literally means ‘hidden testis’. The term is derived from greek word ‘Kryptos’ and ‘Orchis’ meaning ‘hidden’ and ‘testis’ respectively, and refers to the absence of testis from the scrotum. Although some interchangeably call a testis ‘cryptorchid’ or ‘undescended’, the terms are not synonymous, because cryptorchid testis may also be ‘ectopic’, or ‘absent’, while undescended testis typically testifies a testis which is arrested anywhere in the normal course of its descent from the intraabdominal position to the scrotal position. AIM OF THE STUDY: To evaluate the histopathological changes in undescended testes with relation to age and location of the testis in testicular biopsies taken during orchiopexy, which can be helpful to prognostigate on future fertility, and also to look for the presence or absence of intra-tubular germ cell neoplasia. MATERIALS AND METHODS: This prospective study was done from October 2005 to March 2007 over a period of 18 months, in the Department of Pediatric surgery with the assistance of the Department of Pathology the Institute of Child Health and Hospital for Children, Madras Medical College, Chennai. During the above period, testicular biopsies in cases of undescended testes, either unilateral or bilateral undergoing orchiopexies were done on 21 children with 28 biopsy specimens, varying in age from 10 months-10 years. Inclusions criteria : All cases of Undescended testis Exclusive criteria : Retractile and Ectopic testis. The specimens were fixed in Bouin’s solution (saturated aqueous picric acid 75 ml. 40% formaldehyde-25ml, and glacial acetic acid-5ml) for atleast 6 hours for complete fixation, and subjected for histopathological examination. After routine processing, sections of 4-5 micron thickness were made and stained with Hematoxylin and Eosin (H&E) and Masson Trichrome (MTS); viewed under microscope and analysed. Semithin sections were also taken and studied to look for the presence of spermatogonia. Sections were analysed for the number of seminiferous tubules, diameter of the seminiferous tubules, presence of sertoli cells with or without hyperplasia, presence of spermatogonia and the presence or absence of intratubular germ cell neoplasia. Morphometeric analysis of the tubules were done using image analyzer using the Software (Image Pro plus 6) after measuring 50 tubules per section. Peritubular fibrosis, calcification, macrophages and hyalinization were also analysed. RESULTS: 28 testicular biopsies were taken from 21 children undergoing orchiopexy either for unilateral or bilateral testes. Youngest child: 10 months Oldest child: 10 years Of the 21 children, 7 had B/L undescended testes, totalling for 28 biopsies. CONCLUSION: • In our histopathological study of testicular biopsies at the time of orchiopexy, it though showed that all the types of testicular lesions are present in all locations from the intraabdominal to the canalicular region, these changes start occurring as early as 1 year of life and even earlier for eg. (10 months in one child in our study) with more severe lesion type. Therefore the generally recommended timing of orchiopexy now being as 1 year can be reduced even to a still further lower age group. • Classification of prepubertal testis by their histologic type could make it possible to grade the prognosis with regard to fertility in a large numbers of patients who undergo Orchiopexy at an earlier age. • Such studies of prepubertal cryptorchid biopsies comparing them with post pubertal testicular biopsies in laterlife a larger number of cases definitely will help in predicting future fertility. • Also in prepubertal cryptorchid testicular biopsies, it is also possible look for the presence of intra-tubular germ cell neoplasia.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Pericardiectomy ; Constrictive Pericarditis ; Comparative study ; Total and Subtotal Pericardiectomy ; Left Anterolateral Thoracotomy. |
| Subjects: | MEDICAL > Cardio Vascular and Thoracic Surgery |
| Depositing User: | Kambaraman B |
| Date Deposited: | 10 Nov 2017 17:31 |
| Last Modified: | 10 Nov 2017 17:42 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3875 |
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