摘要
目的:比较腹腔镜下精索静脉高位结扎术与显微镜精索静脉低位结扎术的疗效。方法:回顾性分析2015年1月-2018年10月收治52例精索静脉曲张患者的临床资料,其中行保留睾丸动脉的腹腔镜精索静脉曲张高位结扎术28例(A组),行显微镜下低位精索静脉结扎术24例(B组)。对两组患者的手术时间、住院时间、复发率及并发症发生率、两组术前及术后第6个月精子改善情况进行统计学分析。结果:两组患者的手术时间、鞘膜积液的发生率方面差异有统计学意义(P<0.05)。两组患者的住院天数、术后睾丸萎缩发生率及复发率差异无统计学意义(P>0.05)。两组术后6个月精液质量均显著提高,但组间差异无统计学意义(P>0.05)。结论:显微镜下精索静脉结扎术能明显改善精液质量,术后并发症少,是治疗精索静脉曲张的最佳手术方式。而腹腔镜下保留睾丸动脉的精索静脉高位结扎术手术时间短,术后疗效好,也是治疗精索静脉曲张的较好方案。
Objective:To compare the curative effectiveness of laparoscopic selective varicocelectomy and microscopy-assisted low ligation of the spermatic vein in the treatment of varicocele.Methods:We retrospectively analyzed the clinical data of 52 cases of varicocele treated in our hospital from January 2015 to October 2018.The patients in group A(n=28)underwent high selective laparoscopic ligation of spermatic vein,and spermatic arteries were preserved.The patients in group B(n=24)were given microscopy-assisted low ligation of the spermatic vein.The patients were followed up for 12 months,and the operation time,hospital stay,recurrence rate,incidence of complications,and semen quality in two groups before and 6 months after surgery were analyzed statistically.Result:The operation time in group A was significantly shorter than in group B(P<0.05).The incidence of hydrocele of testis in group A was significantly higher than in group B(P<0.05).There was no significant difference in hospital stay,testis atrophy as well as the rate of recurrence between two groups(P>0.05).The semen quality at 6th month after operation in two groups was significantly improved(P<0.05).There was no significant difference in above indexes between two groups(P>0.05).Conclusions:Low-approach microscopic varicocelectomy is of remarkable effect in the improvement of sperm quality,with lower incidence of complications,which is regarded as the best treatment for varicocele.Laparoscopic high selective ligation of spermatic vein has short operation time and high improvement rate of semen quality,which is also an optimal surgical management.
作者
刘立民
迟庆龙
戴小凡
张尧
王超
张守利
LIU Limin;CHI Qinglong;DAI Xiaofan;ZHANG Yao;WANG Chao;ZHANG Shouli(Department of Urology,Central Hospital of Jilin,Jilin 132011,China)
出处
《微创泌尿外科杂志》
2019年第6期421-423,共3页
Journal of Minimally Invasive Urology
作者简介
通信作者:刘立民,liulimin1972@sohu.com
