腹股沟下途径显微技术精索静脉结扎术与腹腔镜精索内静脉高位结扎术的疗效比较

Comparative study of effect of low-approach microscopic and laparoscopic varicocelectomy in treatment of varicocele

目的观察比较两种手术方式治疗精索静脉曲张（VC）的临床疗效。方法将2010年1月至2011年6月就诊的60例VC患者随机均分为两组：A组予以腹股沟下途径显微技术精索静脉结扎术，B组予以腹腔镜单纯精索内静脉高位结扎术。分析两组术后近、远期并发症、复发率及术后精液改善情况等指标，比较两组临床疗效。结果两种手术方式术后精液质量均较术前明显提高（P〈0．05），但组间比较差异无统计学意义（P〉0．05）；两组术后精索水肿、睾丸鞘膜积液等近期并发症差异无统计学意义（P〉0．05）；均未出现睾丸萎缩等远期并发症；但A组复发率低于B组，差异有统计学意义（P〈0．05）。结论两种手术方式治疗VC均有明显临床疗效，但腹股沟下途径显微技术精索静脉结扎术式因其术后复发率更少，且具有操作简便、治愈率高等优点，可作为手术治疗VC的首选。

Objective To evaluate the clinical effects of two surgical methods in the treatment ofspermatic varicocele. Methods From January 2010 to June 2011, 60 patients with VC were randomly divided into Group A and Group B. The patients in Group A underwent microsurgical subinguinal vasectomy, while those in Group B received laparoscopic high ligation of the inner spermatic veins. The short and long-term complications, sperm quality, and clinical effects were comparatively analyzed. Results The quality of sperm in the two groups was all improved significantly after surgery （P〈0.05）. However, no difference was found in sperm quality between the two groups （P〉 0.05）. The short-term complications like sperm edema and hydrocele of testis showed no significant difference between these two groups （P〉0.05）. All patients in the two groups did not have long-term complications. The recurrence rate in Group A was obviously lower than that in Group B（P〈0.05）. Conclusion The two methods all show great advantages in the treatment of spermatic varicocele. Microsurgical subinguinal vasectomy is regarded as the first choice in the treatment of varicocele because the recurrence rate is lower.