改良两孔法腹腔镜手术与开放手术治疗小儿精索静脉曲张的临床比较

Modified two incisions laparoscopic versus open surgery for treatment of varicocele in children

目的 观察改良两孔法腹腔镜手术与开放手术治疗精索静脉曲张的疗效。方法 将本院2012年1月~2014年12月间收治的40例精索静脉曲张患儿随机分为两组,对照组20例采用开放手术,行腹股沟精索静脉高位结扎,治疗组20例采用改良两孔法腹腔镜精索内静脉高位结扎术。观察并比较两组患者疗效。结果 治疗组伤口大小、平均住院时间明显优于对照组,差异有统计学意义（P〈0.001）,两组手术时间、出血量、并发症和复发率差异无统计学意义（P〉0.05）。结论 改良两孔法腹腔镜手术治疗小儿精索静脉曲张是一种安全、有效的术式,患者康复快,疗效确切。

Objective To observe the clinical efficacy of modified two small incisions laparoscopic and open surgery for treating varicocele in children. Methods By using randomized controlled trial,40 children with varicocele who were cared at our hospital from January 2012 to December 2014 were divided into a control group （20 cases） and a study group （20 cases）. Patients in control group underwent open surgery with inguinal high ligation of the internal spermatic vein,whereas patients in study group were given the operation of retroperitoneal ligation of the internal spermatic vein by using modified two--incision laparoscope. The efficacy was observed and compared between the two groups. Results The incision size and the mean hospital duration of the study group were significantly superior to those in the control group （ P 〈0.001）. Comparison of the duration of operation, volume of bleeding, complications and the recurrence rate between the two groups showed there were no statistically significant differences （ P〈 0.05）. Conclusion Modified tow--incision laparoscopic operation is a safe and effective surgical procedure in treating varicocele, and patients can rapidly recover. It has satisfactory results.