精索静脉曲张患者行保留睾丸动脉的高位结扎开放术心得体会

Experience of varicocel high ligation for preserving testicular artery open operation

目的探讨精索静脉曲张患者行保留睾丸动脉的高位结扎手术的技巧及疗效。方法回顾性分析2009年1月～2013年9月本院泌尿科对150例精索静脉曲张患者采用保留睾丸动脉的高位结扎手术，其中有79例行保留睾丸动脉的高位结扎开放术分为A组，71例行未保留睾丸动脉的高位结扎开放术分为B组，对术后并发症、术后复发情况、术前术后精液比较等方面进行回顾性分析探讨。结果150例均顺利完成手术，手术时间（44．8±12．2）min，A组0例、B组1例（1．41％）副损伤。A组2例（2．53％）、B组6例（8．45％）发生切口感染伴发热。术后随访6个月内A组6例（7．59％）、B组11例（15．49％）反复出现患侧精索一过性刺痛，术后随访318个月A组60例（75．95％）、B组38例（53．52％）患者的精子密度及活力提高，其精液质量得到明显改善。A组1例（1．27％）、B组3例（4．23％）出现复发、睾丸萎缩等并发症。结论精索静脉曲张行保留睾丸动脉的高位结扎开放手术是效果好、不易复发、并发症少、安全、有效的手术，值得在没有显微外科的基层医院推广应用。

Objectives To investigate the technical points and effectiveness of high ligation of spermatic vein of keeping arteriae testicularis. Methods To retrospectively analyse 150 cases of varicocele treated in our u- rology from January 2009 to September 2009 . Among them, 79 cases in group A accepted varicocele high ligation with testicular artery retention ,71 cases in group B accepted varicocele high ligation without testicular artery retention The postoperative complications, postoperative relapse, comparison of postoperative semen, etc were retrospectively analyzed. Results 150 cases were successfully completed surgery. The time of operation was44.8 ± 12.2min, and there was no vice - damage during the operations in group A meanwhile lcase in group B. There are 17 postopera- tive follow - up of 6 months （ 11.33 % ） cases of recurrent of spermatic transient tingling, 98 patients （ 65.3 % ） of sperm density and vitality, the semen quality improved significantly. Conclusions Varicocele high ligation with testicular artery retention is safe and effective which deserves popularization and application in the hospital absence of microsurgical grassroots.