两种经脐腹腔镜治疗精索静脉曲张方法的效果比较

Comparison of curative effects on varicocele between two transumbilical laparoscopic treatment methods

目的比较经脐腹腔镜精索血管高位集束结扎术与单纯精索内静脉高位结扎术治疗精索静脉曲张的疗效。方法收集2010年1月～2012年1月在本卫生队行经脐腹腔镜精索静脉曲张结扎术56例,其中Palomo组与Ivanissevich组各28例。比较分析两组围手术期资料。结果两组患者在术中出血量、术后肠道功能恢复时间、住院时间和近远期并发症发生率方面无统计学差异(P>0.05),但Palomo组的手术时间及复发率明显低于Ivanissevich组(P<0.05)。两组术后精液质量较术前均明显提高(P<0.05),但两组间差异均无统计学意义(P>0.05)。结论 Palomo术式的术后复发率低,手术时间短,可作为经脐腹腔镜精索静脉曲张手术治疗的首选。

Objective To make comparison of curative effects on varicocele between Palomo and Ivanissevich. Methods Patients selected were 56 ones who received transumbilical laparoscopic ligation of varicocele in our sanitary corps from January 2010 to January 2012. They were divided randomly and equally into Palomo group and Ivanissevich group and received Palomo operation or Ivanissevich operation, respectively. The perioperative data of both groups were compared with each other. Results There was no significant difference in perioperative blood loss, the recovery time of intestinal function after the operation, length of hospital stay, and the incidence of complications in short and long term between the two groups （P 〉 0.05 ）. But the operative time and recurrence rate in Palomo group were significantly lower than those in Ivanissevich group （P 〈0.05）. The postoperative semen quality of both groups was improved significantly （P 〈0.05）, but there was no significant difference between the two groups （P 〉 0. 05 ）. Conclusion Palomo operation has advantages of low recurrence rate and short operation time and can be selected as the first choice for the surgical treatment of varicocele.