腹腔镜和开放手术精索静脉高位结扎术的疗效分析

Comparison Between Laparoscopic and Open Surgical High Ligation of the Internal Spermatic Vein

目的:评价腹腔镜下精索静脉高位结扎和开放手术治疗精索静脉曲张的疗效。方法:回顾性分析85例腹腔镜下精索静脉高位结扎(腹腔镜组)和47例开放手术(开放手术组)治疗精索静脉曲张的临床资料。结果:腹腔镜组术中损伤小、术后恢复快,手术时间(32.0±5.9)min,基本无出血,术后住院(3.0±1.6)d,随访3～12个月,3例复发,复发率为3.5%。开放手术组手术时间(46.0±7.2)min,术后住院(7.0±3.7)d,随访3～12个月,5例复发,复发率为10.6%。手术时间和术后住院时间腹腔镜组显著低于开放手术组(P<0.05,和P<0.01)结论:腹腔镜下精索静脉高位结扎术治疗精索静脉曲张具有创伤小、恢复快、效果好、并发症少等优点。

Objective ： To compare the effects of laparoscope-guided high ligation of the internal spennatic vein and open surgery in the treatment of varicocele. Methods ： We collected the clinical data of 85 cases of varicocele treated by laparoscope-guided high ligation of the internal spermatic vein （the laparoscopic group） and another 47 that underwent open surgery （the open group） , and compared the results of treatment between the 2 groups. Results ： The operations were successful in all the cases. In the laparoscopic group, the mean operation time was （32.0 ± 5.9） minutes, with little bleeding, and the mean postoperative hospital stay was （ 3.0 ± 1.6） days, with 3 cases （3.5%） of recurrence during the 3 - 12 months follow-up. In the open group, the mean operation time was （46.0 ± 7.2） minutes and the mean postoperative hospital stay was （7.0± 3.7） days, with 5 cases （10.6%） of recurrence during the same length of follow-up. Conclusion ： Laparoscopic method for the treatment of varicocele is obviously superior to open surgery for its advantages of minimal invasiveness, fast recovery, sure effectiveness, few complications and low recurrence, particularly for those with bilateral varicocele who experienced recurrence after open surgery.