腹腔镜保留动脉和淋巴管的精索内静脉结扎术和Palomo术疗效的对比研究

The efficacy of artery-lymphatics sparing laparoscopic varicocelectomy and palomo： a comparative study

目的探讨腹腔镜下保留睾丸动脉和淋巴管的精索内静脉结扎术（Artery-Lymphatics SparingLaparoscopic Varicocelectomy, ALSLV）和精索高位集束结扎术（Palomo）术临床疗效的优劣性。方法对2005年9月至2009年5月间，成功接受ALSLV术的52例（57侧）（ALSLV组）及接受Palomo手术的21例（23侧）（Palomo组）并得到随访的精索静脉曲张不育患者的临床资料进行前瞻性对比研究。结果两组患者术前和本研究相关的特征参数有可比性；ALSLV组平均手术时间明显长于Palomo组（P〈0．05）；两组的平均住院时间、平均治疗费用、VC复发率无显著性差异（P〉0．05）；ALSLV组术后精液参数改善率和自然妊娠率显著高于Palomo组，术后睾丸疼痛、睾丸鞘膜积液及睾丸萎缩发生率显著低于Palomo组（P〈0．05）。结论本组资料显示ALSLV手术耗时稍长，但其临床疗效显著优于Palomo手术，是一种安全、有效、值得推广的手术方式。

Objectives To evaluate clinical efficacy of Artery-Lymphatics Sparing Laparoscopic Varicocelectomy （ALSLV） and Palomo. Methods A prospective comparative study was carried out based on the clinical data of 52 infertility patients who underwent 57 ALSLV and 21 infertility patients who underwent 23 Palomo. Results The patients in 2 groups had comparable preoperative characteristic parameters （P〉0.05）. Mean operation time of ALSLV group was significantly longer than that of Palomo group. No significant differences were found in average stay, mean treatment costs, VC recurrence rate between these 2 groups （P〉0.05）. The sperm parameters improvement rate and spontaneous pregnancy rate of ALSLV group were significant higher than those of Palomo group （P〈0.05）. However, the incidences of testicle pain, testicular hydrocele and orchiatrophy were all significant lower than those of Palomo group （P〈0.05）. Conclusion The results suggested that the clinical efficacy of ALSLV was superior to that of Palomo. ALSLV is a safe, effective, promising treatment for varicocele.