青少年顯微鏡下外環下精索靜脈結紮3例報導並文獻複習

Microsurgical subinguinal varicocelectomy 3 case report and review of the literature

目的探討青少年精索靜脈曲張手術適應症以及顯微鏡下外環下精索靜脈結紮術的安全性和優越性。方法青年男性患者3名,年齡分別為19歲、20歲和22歲,平均年齡20.3歲。一位患者因“左側陰囊隱痛不適半年”就診;另兩位患者無不適主訴,均為體檢發現“雙側精索靜脈曲張”,其中一位伴“左側睾丸體積減小”。三位患者彩超檢查均提示“中到重度精索靜脈曲張伴返流”。三位患者均經術前準備後行硬膜外麻醉下顯微鏡下外環下精索靜脈結紮術。結果術後1週患者陰囊不適感消失,未見陰囊水腫及鞘膜積液徵象。結論顯微鏡下外環下精索靜脈結紮術,術中可以明確鑒別及保護淋巴管、精索內動脈,保證了睾丸的充分的動脈供血及局部淋巴回流,更全面的阻斷病變靜脈分支,且手術可以在局部麻醉或硬膜外麻醉下進行,更加安全、有效。

Objective To investigate the effect and safety of Microsurgical Subinguinal Varicocelectomy in adolescent males with varicocele.Methods 3 adolescent males,average age of 20.3,were diagnosed with bilateral varicocele.1 boy was suffered from left scrotal discomfort,and 2 boys were diagnosed during regular body-check without obvious symptom.All boys were diagnosed as bilateral varicocele confirmed by ultrasonography.The above 3 cases were treated with Subinguinal Varicocelectomy.Results No scrotal discomfort was found.Conclusion Micros-urgical Subinguinal Varicocelectomy is associated with the lowest recurrence and complication rate,and is safe and efficient,comparing to other surgical procedures.