转流术治疗小儿精索静脉曲张

Shunting in varicoceles in children

目的 采用转流术治疗小儿精索静脉曲张 ,重新建立精索静脉通道 ,使静脉回流受阻立即得到改善 ,消除因睾丸淤血而造成的损害 ,以利睾丸的正常发育。方法 对 2 8例 30侧 (左侧 2 6例 ,双侧 2例 )精索静脉曲张与腹壁下静脉进行吻合 ,通过腹壁下静脉 ,髂静脉转流 ,手术在放大镜下应用显微外科技术进行 ,其中 2 8侧用精索静脉主干 ,2侧结扎一条属支 ,用另一条静脉进行吻合。结果 通畅率为 10 0 %。术后扩张迂曲静脉团消失 ,阴囊下坠感消失。术后随访 2 4例 ,时间为 3个月～ 10年。除 1例二次手术证实为一条静脉属支漏扎而复发外 ,另 2 3例全部治愈。结论 精索静脉曲张转流术效果明显优于结扎术 ,可减少因睾丸淤血对其造成的进一步损害 ,且术后复发率低。

Objective To review applying spermatic vein shunting to varicoceles in children.Methods From 1992 to 2001, 26 cases of varicoceles underwent 30 shunting operations (left side 26, both sides 2 ) on anastomosis of testicular vein and inferior epigastric vein. The operation was performed with the microsurgical technique under operating microscope. Main trunks anastomosis were used in 28 cases whereas side branches anastomosis were used in 2.Results The patency rate was 100%. The varicoceles and sense of distention disappeared after the operation. Twenty four patients were followed-up for a period ranging from 3 months to 10 years with one relapse. Conclusions The testicular vein to inferior epigastric vein shunting is a better procedure than simple vascular ligation as it avoids the further congestion of testis. The recurrence rate is lower.