腹腔镜下保留精索淋巴管技术治疗青少年精索静脉曲张

Spermatic Lymphatic Vessels Preservation of Laparoscopic Surgery for Adolescent Varicocele

目的探讨腹腔镜下保留淋巴管技术治疗青少年精索静脉曲张的效果。方法 2015年1月～2016年9月,我院收治青少年Ⅲ度原发性精索静脉曲张12例,年龄11～14岁,平均12.5岁,均为左侧。患侧睾丸明显小于健侧,其中4例运动后阴囊有明显坠胀不适。术中睾丸鞘膜注射1%亚甲蓝,腹腔镜下保留精索淋巴管行选择性精索静脉高位结扎术。观察术后鞘膜积液、睾丸萎缩、复发等情况。结果 12例睾丸鞘膜内注射亚甲蓝后均在腹腔镜下观察到蓝染的精索淋巴管,行保留淋巴管的选择性精索静脉高位结扎术,手术时间36～50 min,平均45 min。术后随访8～18个月,中位数12个月,术后患侧未出现鞘膜积液、精索静脉曲张复发、睾丸坏死萎缩等并发症。结论腹腔镜下保留精索淋巴管的选择性精索静脉高位结扎术效果良好。

Objective aboleseent patients. Methods degree primary varieoeele were entered in this study. Their age was 11 - 14 years old （mean, 12. 5 years old）. The varieoeele occurred on the left side in all the cases. The testis on the afl＇eeted side was absolutely smaller than the unafl＇eeted side. Four cases had apparent discomfort of dragging and distending after exercise. The 1% methylenleneblue was injected in perididymis during the operation. The laparoseopie selective high ligation of spermatie vein retaining the lymphatic vessels was performed. The postoperative hydroeele, the atrophy of testis and the recurrence were observed. Results Blue dyed spermatie lymphatic vessels were observed in all the twelve patients whose perididymis was injected with methylene blue under laparoseopy. The operation time of the selective high ligation of spermatie with the retention of lymphatic vessels ranged from 36 to 50 min （mean, 45 min）. The post-operation follow-ups ranged from 8 to 18 months （median, 12 months）. None of the patients suffered from complications of hydroeele, recurrence of varieoeele or atrophy of testis. Conclusion Good efl＇eet can be obtained through laparoseopie selective high ligation of spermatie with the retention of lymphatic vessels.