通过多模式治疗和造血干细胞移植，大多数被诊断患有恶性肿瘤和血液系统疾病的儿童现在都能存活到成年。由于许多此类治疗具有性腺毒性作用以及未来不孕的可能性，因此在开始治疗之前进行精子冷冻保存的生育咨询是青春期后男性的标准治疗方法。不幸的是，对于青春期前的患者或无法提供样本的患者来说，选择有限。睾丸组织冷冻保存（TTC）是一种通过手术从睾丸组织中获取生殖细胞并有可能恢复未来精子发生的研究方法。虽然 TTC 已被证明是安全的，但有关手术后治疗时间的报道很少，以确保伤口充分愈合并避免最终治疗的延误。主要结果是 TTC 后开始治疗的时间。次要结局是并发症发生率、TTC 导致的治疗延迟以及生殖细胞的存在。我们对 2017 年至 2023 年间接受 TTC 的患者进行了一项单机构回顾性队列研究。根据既定标准，存在治疗相关不孕症显着风险的患者是符合 TTC 资格。如果患者在其他地方接受肿瘤学或血液学护理，则被排除在外。所有患者均参加了 IRB 批准的研究方案，其中 75% 的组织提交用于冷冻保存，25% 用于研究目的。治疗时间定义为 TTC 后首次接受性腺毒性治疗。共有 122 名患者（53 名=恶性，69名=非恶性）接受了 TTC，中位年龄为 5.9 岁（IQR 2.3-9.35）。在 115 个 (94%) 样本中鉴定出生殖细胞。共有 109 名 (89%) 患者接受了伴随手术。恶性和非恶性疾病的开始治疗的中位时间分别为 5 天（IQR 1.0-7.0）和 7 天（IQR 6.0-13.0）。 30 天手术并发症率为 2.5%，恶性与非恶性诊断之间相似 (p = 0.58)。所有手术并发症均通过非手术治疗。没有患者因担心伤口愈合或并发症而延迟最终治疗。我们的手术并发症发生率与之前的研究相似，并且不受 TTC 后治疗时间的影响。该研究的局限性在于其回顾性设计、单一机构和短期随访。TTC 可以安全、有效地进行，并与其他必要的程序结合使用，不会导致最终治疗的延误。 TTC 为没有其他选择的儿童提供保留生育能力的机会。版权所有 © 2024 Journal of Pediatric Urology Company。由爱思唯尔有限公司出版。保留所有权利。

With the use of multimodal treatments and hematopoietic stem cell transplant, the majority of children diagnosed with malignancies and hematologic diseases are now surviving into adulthood. Due to the gonadotoxic effects and potential for future infertility associated with many of these treatments, fertility counseling with sperm cryopreservation prior to starting therapy is the standard of care for post-pubertal males. Unfortunately, the options are limited for pre-pubertal patients or those unable to provide a specimen. Testicular tissue cryopreservation (TTC) is an investigational method to surgically obtain germ cells from testicular tissue and potentially restore future spermatogenesis. While TTC has been shown to be safe, little is reported on the time to treatment following the procedure to ensure adequate wound healing and avoid delays in definitive therapy.The primary outcome was the time to initiation of treatment following TTC. Secondary outcomes were complication rates, delays in treatment due to TTC, and presence of germ cells.We conducted a single-institution retrospective cohort study of patients undergoing TTC between 2017 and 2023. Patients at significant risk for treatment related infertility based on established criteria were eligible for TTC. Patients were excluded if they received their oncology or hematology care elsewhere. All patients were enrolled in an IRB approved research protocol with 75% of the tissue submitted for cryopreservation and 25% for research purposes. Time to therapy was defined as the first receipt of gonadotoxic treatment following TTC.A total of 122 patients (53 = malignant, 69 = non-malignant) underwent TTC with a median age of 5.9 years (IQR 2.3-9.35). Germ cells were identified in 115 (94%) specimens. A total of 109 (89%) patients underwent concomitant procedures. The median time to initiation of therapy was 5 (IQR 1.0-7.0) and 7 days (IQR 6.0-13.0) for malignant and non-malignant disease, respectively. The 30-day surgical complication rate was 2.5% and was similar between malignant vs non-malignant diagnoses (p = 0.58). All surgical complications were managed non-operatively. No patients had a delay in definitive treatment due to concern for wound healing or complications.Our surgical complication rates are similar to previous studies and are not affected by the time to treatment following TTC. Limitations of the study are its retrospective design, single institution, and short-term follow up.TTC can be performed safely, efficiently, and in conjunction with other necessary procedures without resulting in delays of definitive treatment. TTC affords the opportunity for fertility preservation in children who have no other options.Copyright © 2024 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.