显微镜下经腹股沟途径与传统Palomo精索静脉结扎术治疗陆军精索静脉曲张患者术后并发症的比较

Postoperative complications of microscopic versus Palomo varicocelectomy for varicocele in army personnel

目的应用显微镜下保留精索动脉、淋巴的精索静脉高位结扎术与传统的Palomo术治疗陆军精索静脉曲张患者,并对两种术式的术后并发症进行比较。方法选择原发性精索静脉曲张陆军患者260例,根据手术方式随机分为显微镜下经腹股沟途径高选择性保留精索内动脉、淋巴管的精索静脉高位结扎术组(A组,130例)和传统Palomo术组(B组,130例)。比较两组术后阴囊水肿、睾丸疼痛、睾丸萎缩、复发等并发症情况。结果经过1年随访,A、B组术后出现阴囊水肿发生率为3.1%(4/130)、14.6%(19/130),术后睾丸疼痛缓解率分别为90.7%(118/130)、67.7%(88/130),术后睾丸萎缩发生率分别为0.7%(1/130)、3.1%(4/130),A、B组间比较差异有统计学意义(P<0.05);术后复发的发生率分别为5.3%(7/130)、3.8%(5/130),A、B组间比较差异无统计学意义(P>0.05)。结论原发性精索静脉曲张陆军患者,选择在显微镜下保留精索内动脉、淋巴管的精索静脉高位结扎术,术后阴囊水肿、睾丸疼痛、睾丸萎缩的发生率明显降低,而术后复发的机会并未增加。

Objective To evaluate the postoperative complications of microscopic and conventional Palomo varicoceletomy in the treatment of varicocele in army personnel. Methods A total of 260 army personnel with varicocele were randomized to receive microscopic varicocelectomy （group A, n=130） and conventional Palomo varicocelectomy （group B, n=130）. The postoperative recurrence and complications （scrotal edema, testicular pain and testicular atrophy） were compared between the two groups. Results After 1 year of follow-up, the recurrence rates in groups A and B were statistically comparable （5.3% vs 3.8%, P〉0.05）. The incidences of testicular atrophy and scrotal edema were significantly lower in group A than in group B （0.7% vs 3.1%, P〈0.05; 3.1% vs 14.6%, P〈0.05）, and the rate of testicular pain relief was significantly higher in group A （90.7% vs 67.7%, P〈0.05）. Conclusion Microscopic varicocelectomy can be a good choice in the treatment of varicocele in army personnel.