3D视频显微系统在精索静脉曲张显微手术中的应用

Application of 3D video microscope system in microsurgical varicocelectomy

目的 探讨3D视频显微系统在精索静脉曲张显微手术中应用的可行性和有效性。方法 回顾性分析2019年3月至10月于潍坊市中医院、上海交通大学医学院附属第一人民医院接受显微手术治疗的29例精索静脉曲张患者病历资料,根据手术方式分成A组(3D视频显微系统组)14例和B组(传统光学手术显微镜组)15例。比较两组手术者舒适性评分(眼部、颈部、背部、腰部、腕部舒适度评分、眩晕感评分)、图像清晰度评分、手术有效性(手术时间、精索内动脉数目、精索内静脉数目、淋巴管数目、精索外静脉数目、睾丸引带静脉数目)、术后患者并发症(睾丸疼痛、睾丸鞘膜积液、阴囊水肿)发生率。结果 A、B两组手术均顺利完成,A、B两组手术有效性比较,差异无统计学意义(P>0.05)。A、B两组术后并发症发生率比较,差异无统计学意义(P>0.05)。A、B组眼部舒适度评分(4.41±0.50)分vs (4.15±0.44)分、颈部适度评分(4.53±0.51)分vs (4.18±0.52)分、背部适度评分(4.59±0.50)分vs(4.21±0.48)分、腰部适度评分(4.47±0.51)分vs (4.21±0.41)分、腕部舒适度评分(4.66±0.48)分vs (4.35±0.49)分,差异有统计学意义(P<0.05)。A、B组图像清晰度评分(3.63±0.61)分vs (4.03±0.58)分,差异有统计学意义(P<0.05)。A、B组眩晕感评分(4.22±0.55)分vs (4.29±0.46)分,差异无统计学意义(P>0.05)。结论 3D视频显微系统辅助的精索静脉曲张显微手术效果良好,并可显著改善手术者的术中舒适度。

Objective To investigate the feasibility and efficiency of 3D video microscope assisted microsurgical varicocelectomy. Methods From March, 2019 to Octomber, 2019, clinical data of 29 patients with varicocele who underwent microsurgical varicocelectomy were retrospectively analyzed. According to the mode of operation, the patients were divided into group A(14 patients) and group B(15 patients).The patients in group A received 3D video microscope assisted operation, and the patients in group B received traditional operating microscope operation. The comfort score,dizziness score, image clarity, operative effectiveness, and complication rate were comparatively analyzed between two groups. Results All the operations of the two groups were successfully completed. There was no significant difference in the effectiveness between group A and group B(P > 0.05). There was no significant difference in the complication rate between the two groups(P > 0.05). Group A had higher scores for eye comfort(A: 4.41±0.50 vs B: 4.15±0.44, P < 0.05),neck comfort(A:4.53±0.51 vs B:4.18±0.52, P < 0.05), back comfort(A:4.59±0.50 vs B: 4.21±0.48, P < 0.05), waist comfort(A: 4.47±0.51 vs B:4.21±0.41, P < 0.05), and wrist comfort(A: 4.66±0.48 vs B:4.35±0.49, P < 0.05), and lower score for image clarity(A: 3.63±0.61 vs B: 4.03±0.58, P < 0.05) than those of group B. There was no difference in dizziness score between the group A and group B(A: 4.22 ± 0.55 vs B: 4.29 ± 0.46, P > 0.05). Conclusion The 3D video microsurgery system could be applied to perform microsurgical varicocelectomy, and significantly improve the intraoperative comfort of the surgeons.