外环下显微精索静脉结扎术手术体会

Surgical experience of microsurgical subinguinal varicocelectomy

目的:探讨外环下显微精索静脉结扎术(microsurgical subinguinal varicocelectomy,MSV)的手术经验。方法:回顾性分析自2013年5月至2016年5月共528例精索静脉曲张(varicocele,VC)患者行MSV的临床资料。结果:所有患者顺利完成手术,单侧手术时间(48.1±5.1)min,双侧手术时间(88.2±4.8)min。488例获访的患者术后阴囊水肿10例(2.01%);附睾炎3例(0.61%),复发5例(1.02%),无睾丸鞘膜积液、睾丸萎缩等情况发生。结论:MSV术后疼痛较少,恢复快,是VC理想的手术方式。熟悉外环下精索显微解剖,遵循手术操作原则,利用手术技巧,就能够顺利完成外环下MSV。

Objective： To discuss the surgicalexperience of microsurgical subinguinal varicocelectomy（ MSV）. Methods： The clinical data of 528 patients with varicocele（ VC） treated by MSV from May 2013 to May2016 were retrospectively analyzed. Results： MSV of all patients were successfully completed and the operation times for the left and both sides were（ 48. 1 ± 5. 1） min and（ 88. 2 ± 4. 8） min respectively. In the 488 patients followed up,there were 10 cases（ 2. 01%） of scrotum edema,3 cases（ 0. 61%） of epididymitis and 5 cases（ 1. 02%）of recurrence,withouthydrocele of testis and testicular atrophy. Conclusions： With less postoperative pain and fast recovery,MSV is the best operation method for VC. It is helpful for the completion of MSV to be familiar with the microsurgical anatomy,follow the principle of operation and grasp surgical skills.