显微外科技术在精索静脉曲张手术中的选择性应用

Selective Application of Microsurgical Techniques in the Varicocele Surgery

目的探讨应用显微外科技术在精索静脉高位结扎术中的选择性应用标准。方法对应用显微外科技术和未用显微外科技术手术治疗精索静脉曲张在不同手术路径下的临床资料进行回顾性分析。结果经腹股沟途径,不用和应用显微外科技术手术时间分别为(35.4±5.7)min、(33±8.6)min;经腹膜后途径,不用和应用显微外科技术手术时间分别为(20±5.7)min、(23±7.0)min。在术后随访中,经腹股沟途径,应用显微外科技术未见复发,出现鞘膜积液占1.9%;不用显微外科技术,复发占18.7%。出现睾丸鞘膜积液占14.0%。经腹膜后途径,用显微外科技术,复发占2.9%.未出现睾丸鞘膜积液;不用显微外科技术复发占2.2%。出现睾丸鞘膜积液占1.1%。结论针对不同程度的精索静脉曲张的患者采用内环压迫试验进行简单的手术方式的选择,阳性患者采用直视下腹膜后精索静脉高位结扎术,阴性者采用腹股沟途径显微技术精索静脉结扎术,可使患者在手术成功率,手术成本,手术并发症的发生率上得到一个较好的平衡。

Objective To investigate the microsurgical technique in the high ligation of the spermatic vein in the selective application of standards.Methods Microsurgical technique and no use of microsurgical technique to surgical treatment of varicocele were retrospectively analyzed the clinical data in different surgical path.Results The groin way,not and microsurgical technique,operation time,respectively（35.4±5.7）min,（33±8.6）min;retroperitoneal approach,do not and application of microsurgery in operation for time（20±5.7）min,（23±7.0）min.In the postoperative follow-up after inguinal way,microsurgical technique,no recurrence appear hydrocele accounted for 1.9%;without microsurgical techniques,the recurrence accounted for 18.7%.Testicular hydrocele accounted for 14.0%.The retroperitoneal approach,using microsurgical techniques,the recurrence（2.9%）.Does not appear hydrocele;without microsurgical techniques recurrence accounted for 2.2%.Testicular hydrocele accounted for 1.1%.Conclusion For patients with varying degrees of varicocele inner oppression test for the simple choice of surgical approach-positive patients to look directly into the next peritoneum varicocele ligation,negative groin ways microscopy spermatic vein ligation,patients can get a better balance in the surgical success rate,cost of surgery,the incidence of surgical complications.