显微镜精索静脉结扎术与腹腔镜精索静脉高位结扎术治疗原发性精索静脉曲张的效果对比

Effect comparison of microscopic varicocele ligation and laparoscopic varicocele high ligation in the treatment of primary varicocele

目的比较显微镜精索静脉结扎术与腹腔镜精索静脉高位结扎术治疗原发性精索静脉曲张的效果。方法回顾性分析福建省立医院及福建省立金山医院泌尿外科2015年1月~2018年6月收治的90例原发性精索静脉曲张患者的临床资料,按照手术方法分为腹腔镜组(42例)和显微镜组(48例)。显微镜组采用显微镜手术,腹腔镜组采用腹腔镜手术。比较两组的手术时间、术中出血量、睾丸动脉识别率、住院时间、术后并发症发生情况、静脉曲张复发情况。结果显微镜组的手术时间长于腹腔镜组,差异有统计学意义(P<0.001);显微镜组的睾丸动脉识别率高于腹腔镜组,差异有统计学意义(P=0.007);显微镜的术中出血量少于腹腔镜组,差异有统计学意义(P<0.001);两组的住院时间比较,差异无统计学意义(P=0.609);显微镜组的阴囊水肿、术后2年睾丸萎缩、术后2年复发率低于腹腔镜组,差异有统计学意义(P<0.05)。结论显微镜精索静脉结扎术治疗原发性精索静脉曲张的疗效优于腹腔镜精索静脉高位结扎术。

Objective To compare the effect of microscopic varicocele ligation and laparoscopic varicocele high ligation in the treatment of primary varicocele.Methods The clinical data of 90 patients with primary varicocele admitted to the Department of Urology of Fujian Provincial Hospital and Fujian Provincial Jinshan Hospital from January 2015 to June 2018 were retrospectively analyzed.According to the operation method,they were divided into the microscope group(48 cases)and the laparoscopic group(42 cases).The microscope group was treated with microscopic varicocele ligation,the laparoscopic group was treated with laparoscopic varicocele high ligation.The operation time,blood loss,testicular artery recognition rate,hospitalization time,postoperative complications and varicose recurrence were compared between the two groups.Results The operation time of the microscope group was longer than that of the laparoscopic group,the difference was statistically significant(P<0.001).The recognition rate of testicular artery in the microscope group was higher than that in the laparoscopic group,the difference was statistically significant(P=0.007).The intraoperative blood loss of the microscope group was less than that of the laparoscopic group,the difference was statistically significant(P<0.001).There was no significant difference in the hospitalization time between the two groups(P=0.609).The scrotal edema,testicular atrophy in 2 years after operation and recurrence rate in 2 years after operation in the microscope group were lower than those in the laparoscopic group,the differences were statistically significant(P<0.05).Conclusion The curative effect of microscopic varicocele ligation is better than that of laparoscopic varicocele high ligation.