Abstract：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
刘立民, 迟庆龙, 戴小凡, 张尧, 王超, 张守利. 腹腔镜与显微镜精索静脉结扎术的疗效比较[J]. 微创泌尿外科杂志, 2019, 8(6): 421-423.
LIU Limin, CHI Qinglong, DAI Xiaofan, ZHANG Yao, WANG Chao, ZHANG Shouli. Comparison of curative effectiveness between microscopic and laparoscopic approach in varicocelectomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(6): 421-423.
[1] 刘星辰,胥芸芸,王芳,等.青少年原发性精索静脉曲张诊治进展.中国男科学杂志,2016,30(6):69-72. [2] LOCKE JA, NOPARAST M, AFSHAR K.Treatment of varicocele in children and adolescents: A systematic review and meta-analysis of randomized controlled trials. J PediatrUrol, 2017,13(5):437-445. [3] 刘健男,刘亚东,杨可来尔,等.精索静脉曲张外科治疗概述及有效性分析.现代泌尿外科杂志,2018,23(1):73-76. [4] 罗晟,张孝斌,程帆,等.开放和腹腔镜手术治疗精索静脉曲张的Meta分析.现代泌尿外科杂志,2013,18(2):130-133. [5] NORK JJ, BERGER JH, CRAIN DS.Youth varicocele and varicocele treatment: a meta-analysis of semen outcomes. Fertil Steril, 2014,102(2):381-U106. [6] 唐启胜,王磊,李瑞晓,等.腹腔镜下高选择性精索静脉高位结扎与显微镜下低位精索静脉结扎术的疗效对比.中华男科学杂志,2018,24(9):782-787. [7] 王晓明,白云金,韩平,等.腹腔镜精索静脉曲张高位结扎日间手术的可行性及安全性分析.现代泌尿外科杂志,2017,22(3):169-172. [8] 江专新,覃云凌,于建红,等.局麻下显微外科曲张精索静脉结扎术疗效与安全性评价(附62例报道).中国男科学杂志,2014,28(12):48-49. [9] BAAZEEM A, BELZILE E, CIAMPI A, et al.Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol, 2011,60(4):796-808. [10] 彭靖,龙海,袁亦铭,等.显微镜下和腹腔镜下精索静脉结扎术的疗效比较.北京大学学报(医学版),2014,46(4):541-543. [11] 葛建章,刘玉明,傅发军.显微镜与腹腔镜精索静脉结扎术临床疗效比较.黑龙江医学,2019,43(4):350-351. [12] WANG J, XIA SJ, LIU ZH, et al.Inguinal and subinguinal micro-varicocelectomy, the optimal surgical management of varicocele: a meta-analysis. Asian J Androl, 2015,17(1):74-80. [13] 黄泽海,梁燊,王子明,等.3种手术方式治疗成人精索静脉曲张疗效比较.实用医学杂志,2018,34(23):3929-3932. [14] BINHAZZAA M, BOUNASR E, PEREZ G, et al.Comparison of subinguinal microsurgical varicocelectomy vs percutaneous embolization in infertile men. Prog Urol, 2016,26(16):1178-1184.
