摘要
目的探讨腹腔镜在精索内静脉高位结扎术中的临床应用价值。方法选取本院收治的精索静脉曲张患者157例，随机分为3组：精索全结扎组（A组）、保留睾丸动脉组（B组）、保留睾丸动脉与淋巴管组（C组），行腹腔镜手术治疗，比较各组的精液质量改善情况以及并发症的发生率。结果①各组术后精液质量较术前均明显提高，其中C组改善最明显，与A组相比有极明显差异，与B组相比无统计学差异；B组与A组相比有明显差异。②C组继发性鞘膜积液的发生率最低；B组虽低于A组，但无统计学意义。C组与B组睾丸萎缩的发生率明显低于A组，有统计学差异。三组术后复发的发生率两两比较无明显统计学差异。结论保留精索淋巴管道可降低术后的发生率，较精索全结扎更有利于精液质量的改善，与保留睾丸动脉比较，其精液质量也有一定的改善，尽管无统计学意义上的差别；保留睾丸动脉可降低术后睾丸萎缩的发生率，较精索全结扎有利于精液质量的改善。
Objectives To investigate the clinical value of laparoscopy in ligation of spennatic veins. Methods 157 patients diagnosed with varicocele were enrolled in the study. All cases were randomized into three groups： ligatian of spermatic vessels group （ group A）, testicular artery sparing group （ group B）, testicular artery and lymph vessels sparing group （ group C）. The therapeutic effects after three different kinds of operation were evaluated by improvement of semen quality and complications related to operation. Results （1）The quality of semen in all groups was improved after operation compared with that of before operation. Significant improvement of semen quality was found in group C when compared with group A. The quality of semen postoperatively was better in group B than in group A. However, no statistical difference was found between group C and group B. （2）The rate of hydrocele in group C was lowest, obviously lower than group A and group B. Although, the rate of hydrocele in group B was slightly lower than group A, no statistical difference could be found. The rates of testicular atrophy in group C and group B were lower than group A. When the recurrence rate were evaluated, group A, group B and group C showed similar results. Conclusions The rate of hydrocele can be reduced by sparing lymph vessels ligation of permatic veins. The quality of semen can be significantly improved by sparing lymph vessels in laparoscopic varicocele ligation. Furthermore, although no statistical difference of sperm quality is found between lymph sparing group and testicular artery sparing group, it is seemed that improvement of semen in lymph sparing group is better. Preservation of testicular artery can improve the semen quality and reduce the rate of testicular atrophy after operation.
出处
《国际泌尿系统杂志》
2012年第2期188-192,共5页
International Journal of Urology and Nephrology
