输尿管镜下双孔腹腔镜精索静脉高位结扎术的初步临床应用

Application of ureteroscope-assisted laparoscopic varicocelectomy with two trocars only:a clinical report of 11 cases

目的:评估输尿管镜下双孔腹腔镜精索静脉高位结扎术的应用价值。方法:回顾性分析2008年6月至2009年6月11例精索静脉曲张患者采用输尿管镜下双孔腹腔镜精索静脉高位结扎术的治疗效果及安全性,随访3～15个月。结果:11例患者术前精子计数为(1 463±128)×104/ml,11例手术均获成功,手术时间为16～28 min,平均(19.4±1.1)min,术中无出血,无肠管及血管损伤。术后无需用镇痛药,术后第1日下床活动,第3日出院,疗效满意。术后3个月精子计数为(2 609±208)×104/ml,与术前相比有明显提高,差异有统计学意义(P<0.01);随访中未见精索静脉曲张复发,无睾丸萎缩发生。结论:输尿管镜下双孔腹腔镜精索静脉高位结扎术疗效确切、并发症少、恢复较快且具有简便易行、微创美观等优点。

Objective：To evaluate the application of ureteroscope-assisited laparoscopic varicocelectomy with two trocars only.Methods： We retrospectively analyzed the clinical efficacy and safety of ureteroscope-assisited laparoscopic varicocelectomy with only two trocars in management of 11 patients with grade Ⅱ-Ⅲ varicocele,who were treated in our hospital between Jun.2008 to Jun.2009 and were followed up for 3-15 months.Results： The operation was successful in all the 11 cases.The mean operation time was（19.4±1.1）min（ranging 16-28 min）.There were no complications after the procedure;the patients were allowed for ambulation on the next day after operation and were discharged on the third day.The sperm count was（2 609±208）×10^4/ml three months after operation,which was significantly higher than that before operation（1 463±128） ×10^4/ml（P〈0.01）.There was no recurrence or testis atrophy.Conclusion： Ureteroscope-assisited laparoscopic varicocelectomy with only two trocars is safe,effective,and easy-to-perform,and it has less complications and trauma.