腹腔镜集束性精索内血管高位结扎术治疗双侧精索静脉曲张的疗效分析(1)
摘要：目的 分析腹腔鏡下集束性精索内血管高位结扎术治疗双侧精索静脉曲张的可行性及临床疗效。方法 回顾性分析本院2016年6月～2018年3月收治的双侧精索静脉曲张并实施腹腔镜下集束性精索内血管高位结扎术治疗患者78例，比较术前与术后6个月睾丸大小及精液质量;评估手术疗效、术后复发及术后并发症发生情况。结果 纳入的78例患者手术均成功，手术时间为(24.80±5.50)min，术中出血<5 ml;平均住院时间(5.10±0.80)d;除3例失访，其余75例患者，术后6个月睾丸体积均较术前增大，术后精液质量较术前提高(P<0.05);患者均无睾丸萎缩发生，临床症状明显缓解，1例患者术后第5个月复发，为结扎丝线滑脱所致;4例患者发生附睾炎(5.33%)，经常规治疗均好转。结论 腹腔镜下集束性精索内血管高位结扎术治疗双侧精索静脉曲张安全可靠、疗效明显、并发症少、复发率低且对术后患者睾丸功能的恢复效果显著，可常规应用于临床。
关键词：精索静脉曲张;腹腔镜;集束性精索内血管高位结扎术;男性不育
, http://www.100md.com
中图分类号：R699 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.038
文章编号：1006-1959(2019)01-0125-03
Therapeutic Effect of High Ligation of Laparoscopic Clustered Spermatic Cord in the Treatment of Bilateral Varicocele
GAO Pan，WANG Zhi-yong，ZHAO Xin-bo，DU Guo-wang，CHEN Hao
(Department of Urology，Affiliated Hospital of Chengde Medical College，Chengde 067000，Hebei， China)
, 百拇医药
Abstract：Objective To analyze the feasibility and clinical efficacy of laparoscopic high ligation of choroidal spermatic cord in the treatment of bilateral varicocele. Methods A retrospective analysis of 78 patients with bilateral varicocele admitted to our hospital from June 2016 to March 2018 and laparoscopic ligation of high intravascular ligation of the spermatic cord was performed.The testicular size and semen quality were compared before and 6 months after surgery; the surgical outcome， postoperative recurrence and postoperative complications were evaluated. Results All the 78 patients were successfully operated. The operation time was (24.80±5.50) min， the intraoperative blood loss was <5 ml; the average hospitalization time was (5.10±0.80) d; except for 3 cases lost to follow-up， the remaining 75 patients were followed up. The testicular volume increased in 6 months compared with preoperative， and the quality of postoperative semen was higher than that before operation (P<0.05). There was no testicular atrophy in the patients， and the clinical symptoms were relieved. 1 patient relapsed in the 5 month after operation. The ligation of the silk thread was caused by slippage; 4 patients developed epididymitis (5.33%)， which was improved by conventional treatment. Conclusion Laparoscopic high-level ligation of clustered spermatic cord for the treatment of bilateral varicocele is safe， reliable， effective， less complication， low recurrence rate and significant recovery of testicular function in postoperative patients. It can be routinely used in clinical practice., http://www.100md.com(高攀 王志勇 赵新博 杜国望 陈昊)
关键词：精索静脉曲张;腹腔镜;集束性精索内血管高位结扎术;男性不育
, http://www.100md.com
中图分类号：R699 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.038
文章编号：1006-1959(2019)01-0125-03
Therapeutic Effect of High Ligation of Laparoscopic Clustered Spermatic Cord in the Treatment of Bilateral Varicocele
GAO Pan，WANG Zhi-yong，ZHAO Xin-bo，DU Guo-wang，CHEN Hao
(Department of Urology，Affiliated Hospital of Chengde Medical College，Chengde 067000，Hebei， China)
, 百拇医药
Abstract：Objective To analyze the feasibility and clinical efficacy of laparoscopic high ligation of choroidal spermatic cord in the treatment of bilateral varicocele. Methods A retrospective analysis of 78 patients with bilateral varicocele admitted to our hospital from June 2016 to March 2018 and laparoscopic ligation of high intravascular ligation of the spermatic cord was performed.The testicular size and semen quality were compared before and 6 months after surgery; the surgical outcome， postoperative recurrence and postoperative complications were evaluated. Results All the 78 patients were successfully operated. The operation time was (24.80±5.50) min， the intraoperative blood loss was <5 ml; the average hospitalization time was (5.10±0.80) d; except for 3 cases lost to follow-up， the remaining 75 patients were followed up. The testicular volume increased in 6 months compared with preoperative， and the quality of postoperative semen was higher than that before operation (P<0.05). There was no testicular atrophy in the patients， and the clinical symptoms were relieved. 1 patient relapsed in the 5 month after operation. The ligation of the silk thread was caused by slippage; 4 patients developed epididymitis (5.33%)， which was improved by conventional treatment. Conclusion Laparoscopic high-level ligation of clustered spermatic cord for the treatment of bilateral varicocele is safe， reliable， effective， less complication， low recurrence rate and significant recovery of testicular function in postoperative patients. It can be routinely used in clinical practice., http://www.100md.com(高攀 王志勇 赵新博 杜国望 陈昊)