传统经腹股沟、显微技术和腹腔镜精索静脉结扎术后并发症发生率的对比研究

Incidence of complications:a comparative study of open inguinal,laparoscopic and microsurgical inguinal varicocelectomy

目的探讨经腹股沟切口显微精索静脉结扎术与传统经腹股沟、腹腔镜技术精索静脉结扎术的安全性。方法回顾性分析自2005年6月至2006年12月间收治的118例精索静脉曲张患者(156侧)3种不同术式术后并发症的发生率,其中60例采用经腹股沟途径显微技术,40例采用传统经腹股沟技术,18例采用腹腔镜精索静脉结扎术。随访时间6～12个月。结果显微技术、传统经腹股沟途径、腹腔镜技术精索静脉结扎术后阴囊水肿发生率分别为0%(0/76)、6%(3/50)、3.4%(1/30);复发率分别为1.67%(1/76)、7.5%(4/50)、6.7%(2/30),三组均未见睾丸萎缩。经统计学分析,显微技术阴囊水肿发生率低于另外两组(P<0.05)。复发率及睾丸萎缩发生率在三组间无统计学差异。结论较传统经腹股沟途径和腹腔镜技术精索静脉结扎术,经腹股沟途径显微技术未发生术后阴囊水肿,曲张复发率低,是一种值得推广的安全术式。

Objective Varicocele therapy is a controversial issue, with no single approach adopted as the best therapeutic option,a variety of surgical approaches have been advocated for varicocele repair. We compared the postoperative complications of the techniques of varicocelectomy in infertile patients with varicocele. Methods From June 2005 to December 2006, 118 patients （156 varicocele） for varicocele correction, including 60 cases of microsurgical inguinal varicocelectomy （MV）, 40 cases of open inguinal varicocelectomy （OV）, and 18 cases of laparoscopic varicocelectomy ,（LV）, were performed at our institution . The complications for each procedure were retrospectively evaluated, Results The follow-up period range 6-12 months. At follow up none of the patients in the microsurgical group had hydrocele, while it was % （4/ 50） in the open group and % （2/30）in the laparoscopy group, representing a significance difference in favor of microsurgery. The incidence of recurrent varicocele was significantly lower in the microsurgical group than in the open and laparoscopy groups （1.3%,6% and 3.4 %, respectively）. Atrophy of testis was not happened in three groups. Conclusions Compared with open and laparoscopic varicocele treatment ,microsurgical varicocelectomy can significantly reduce the incidence of complications.