腹腔镜手术与开放手术治疗精索静脉曲张的临床对照研究

Treatment for patients with varicocele by using laparoscope and patent operation: a prospective randomized controlled study

目的观察腹腔镜手术与开放手术治疗精索静脉曲张的疗效。方法 采用随机分组的方法,将2009年1月～2010年12月间本院收治的83例精索静脉曲张患者分为两组,对照组41例采用开放手术,行腹膜后精索静脉高位结扎,治疗组42例采用腹腔镜精索内静脉高位结扎术。观察并比较两组患者疗效。结果两组手术均获成功,无并发症发生。治疗组单侧精索静脉曲张患者的平均手术时间与对照组无明显差异(P>0.05),而双侧的平均手术时间显著短于对照组,差异有统计学意义(P<0.01);治疗组的平均住院时间亦显著短于对照组(P<0.01)。随访3月～2年,两组患者均无复发,两组的症状改善率和精液改善率无明显差异(P>0.05)。结论腹腔镜精索内静脉高位结扎术治疗精索静脉曲张疗效确切,为治疗精索静脉曲张提供了一种可供选择的方法。

Objective To observe the clinical efficacy of treatment for patients with varicocele by using laparoscope and patent operation. Methods By using randomized controlled trail, 83 cases with varicocele who stayed and were treated in our hospital were divided into control group （41 cases） and study group （42 cases） from Jan 2009 to Dec 2010. Cases in control group were given the operation of retroperitoneal ligation of the internal spermatic vein by using patent operation,whereas cases in study group were given the operation of retroperitoneal ligation of the internal spermatic vein by using laparoscope. Observed and compared the efficacy between two groups. Results The operations of two groups were performed successfully and no complications occurred in our study. The average operative times of unilateral varicocele in study group had not significant difference with control group, but the average operative times of bilateral varicocele in study group was significantly shorter than that in control group. The average time of hospital stay in study group was shorter than that in control group. There were significant difference between two groups（P0.05）. Follow-up of 3 months～2 years duration showed good results. The improvement rate of sign and semen in two groups were not significantly different（P0.05）. Conclusion The operation of retroperitoneal ligation of the internal spermatic vein in patients with varicocele by using laparoscope has the advantage of confirmed effect, it is an alternative operative method of treatment for patients with varicocele.