腹腔镜下腹股沟内环近端2cm精索静脉的应用解剖

Laparoscopic Anatomic Characteristics of Spermatic Vein in the 2cm above Internal Inguinal Ring Area

目的研究腹腔镜下腹股沟内环近端2cm精索静脉曲张患者的精索内静脉的解剖特点。方法收集本院泌尿外科自2014年1月至2018年10月收治265例原发性精索静脉曲张的临床资料,予行腹腔镜下腹股沟内环近端2cm精索静脉高位结扎术,术中分别记录左右的静脉数并观察精索静脉和睾丸动脉关系。结果39例左侧精索静脉曲张患者腹股沟内环近端2cm精索内静脉数为(2. 41±0. 79)支,226例双侧精索静脉患者左侧精索内静脉数为(2. 27±0. 80)支,右侧精索内静脉数为(2. 05±0. 76)支。226例双侧精索静脉曲张患者左右侧精索内静脉数差异有统计学意义(P≤0. 05)。结论腹腔镜下腹股沟内环近端2cm精索静脉解剖结构明确,静脉数量及动脉分布有一定特点,能有效避免静脉漏扎,为腹腔镜下精索静脉高位结扎术提供解剖学基础。

Objective To study the anatomic characteristics of spermatic vein,in the 2 cm above internal inguinal ring area,through the varicocele patient under the laparoscopic varicocelectomy. Methods The clinical data of 265 patients with primary varicocele in our hospital from January 2014 to November 2018 were collected and retrospectively analyzed. All patients underwent laparoscopic varicocelectomy,the ligation of the spermaitc veins were performed 2 cm above internal inguinal ring. The numbers of left and right side spermatic veins were recorded respectively. And the locations of the spermatic veins and testicular arteries were also observed and recorded. Results In 39 patients with left varicocele,The number of spermatic veins was( 2. 41 ± 0. 79) at 2 cm above internal inguinal ring. In 226 patients with bilateral varicocele,the number of veins in the left was( 2. 27± 0. 80),and( 2. 05 ± 0. 76) in the right side. There was a statistical difference in the number of spermatic veins between these two sides in 226 patients( P ≤ 0. 05). Conclusions The anatomic structure under laparoscopy is clear at 2 cm above internal inguinal ring,the quantity of veins and the distribution of arteries have certain characteristics,which can effectively avoid the omission of the spermatic vein,and provide anatomical basis for the upper ligation of spermatic vein under the laparoscopy.