Abstract：Objective： To explore the safety and effectiveness of microsurgical ligation of spermatic vein under local anesthesia in daytime operation. Methods： Retrospective analysis was performed on 100 patients with primary varicocele （VC） admitted to the Urology Department of the First Affiliated Hospital of Yangtze University from April 2018 to December 2019. According to different modes of hospitalization, 50 patients served as the daytime operation group （study group） and 50 patients as the conventional operation group （control group. Patients in the study group were treated with micro VC ligation in daytime operation mode, and those in the control group underwent the routine operation under local anesthesia. The patients were followed up at 1st week to the 12th month after the operation. The hospitalization costs and surgical effects of different hospitalization modes were compared and analyzed. Results： All the surgeries were performed under local anesthesia. The intraoperative pain score was （2.8 ± 0.6）, and the pain score at 4th h after operation was （3.1 ± 0.8）, and both were tolerable levels. Hospitalization costs in the study group were significantly lower than those in the control group （6 618 ± 267 vs. 8 835 ± 312 Yuan RMB, P < 0.05）. One case of complication occurred in both groups at 1st week after operation. After one year of follow up, one case was lost in both groups, and no complications or recurrence were found. There were 33 cases （73.3%） of semen quality improvement in the study group, 32 cases （71.1%） in the control group; 39 cases （88.6%） of scrotal discomfort improvement in the study group, and 37 cases （88.1%） in the control group. There was no statistically significant difference between the two groups （P > 0.05）. Conclusion： Microsurgical ligation of spermatic vein under local anesthesia is safe and effective in daytime operation, and it has the advantages of operation under local anesthesia, short hospital stay and low cost. The next step is to increase the sample size and conduct randomized controlled studies to provide more evidence-based medical evidence for the daytime operation of VC.
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