腹腔镜精索静脉高位结扎术治疗原发性精索静脉曲张589例分析

Laparoscopic High Ligation of Spermatic Vein for Treatment of Primary Varicocele Analysis of 589 Cases

摘 要：目的 探讨经腹腔镜手术治疗精索静脉曲张的疗效及安全性.方法 回顾性分析从1998年7月～2009年9月期间我院589例应用腹腔镜精索静脉高位结扎术治疗原发性精索静脉曲张的患者资料.结果 除1例患者在建立气腹过程中刺破腔静脉手术失败外,其余均获成功,精索静脉曲张全部治愈.术后随访12～24个月,548例（93%）患者临床症状消失,无复发,无睾丸坏死或萎缩表现,24例（4%）患者不同程度复发,17例（3%）患者出现慢性附睾炎.结论 腹腔镜精索静脉高位结扎术治疗精索静脉曲张具有损伤小、痛苦小、康复快、复发率低等优点,简单易行,对双侧精索静脉曲张及开放手术后复发的患者尤有临床价值.

Objective To explore the efficacy and safety of laparoscopic high ligation of spermatic vein for treatment of varicocele. Methods The clinical data of 589 cases with varicocele from July 1998 to Sep. 2009 underwent laparoscopic high ligation of spermatic vein were reviewed. Results Only one case was failed due to puncture inferior vena cava,other cases succeeded. Varicocele was healed. During the follow-up of 12 to 24 months,the symptoms of 548 cases（93% ） disappeared,no patients recurred,no patients had testicular necrosis or atrophy,24 cases（4% ） recurred,17 cases（3% ） appeared chronic epididymitis. Conclusion Laparoecopic treatment for varicocele has advantage of minimal invasion ,faster recovery and effectiveness, especially for recurrent and bilateral varicocele patients.