美蓝造影术在经脐单孔腹腔镜精索静脉高位结扎术中的应用

Application of introperative blue venography during varicocelectomy by transumbilical single port laparoscopy

目的:探讨美蓝静脉造影在经脐单孔腹腔镜精索静脉高位结扎术中的应用价值。方法:回顾分析23例精索静脉曲张患者的临床资料,术中于精索内静脉及精索外静脉注入美蓝稀释液,曲张静脉均结扎,保留精索内动脉。结果:本组23例均顺利完成手术,单侧用时20～35 min,平均28 min;双侧用时45～60 min,平均53 min。无明显并发症发生。术后8 h开始下床活动,住院3～7 d,平均5 d。术后随访,无一例复发,患者睾丸胀痛或下坠感等症状完全消失;2例术后精索鞘膜积液,保守治疗3个月吸收。结论:经脐单孔腹腔镜精索静脉高位结扎术中应用美蓝行静脉造影检测侧支曲张静脉是可行的,可明显降低术后复发率,疗效确切。

Objective：To study the value of methylene blue venography during transumbilical single port laparoscopie varieoee- leetomy. Methods：Clinical data of 23 patients with varh＇ocele were analyzed retrospectively, Diluted methylene blue used to have a in- terorprative venography was injected into distal segment of the spermatic veins fbr detecting the completeness of collateral hranches;liga- ted varicose veins and preserved internal spermatic artery in 23 patients with varieocele. Results： All of the operations were suceessfhl with an average of 28 rain （unilateral,20-35 rain） and 53 rain（bilateral ,45-60 rain） ,no significant eomplication oecurred. Offbed av- tivity time was 8 h and hospitalization time was an average of 5 d（3-7 d）. The postoperative follow-up revealed that there was no recur- fence and the sense of distending pain or bearing down of testis disappeared completely;2 cases of hydrocele of the spermatic eord were absorbed with conservative treatment for 3 months. Conclusions ： The using of methylene blue venography during transumhilical single port laparoscopic varicocelectomy to detect neglected varieocele is feasible and etlective,it eau also significantly reduce the t^em＇rence at^er surgery.