微切口经腹腔腹膜后精索静脉高位结扎术的临床研究
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摘要
目的首次报道了微切口经腹腔腹膜后精索静脉高位结扎术治疗精索静脉曲张的临床疗效。方法选择2016年1月—2017年12月本院收治的60例左精索静脉曲张患者作为研究对象,随机分成研究组和对照组两组,每组各30例。研究组行微切口经腹腔腹膜后精索静脉高位结扎术,对照组行经腹股沟精索静脉高位结扎术。观察和比较两组患者术中出血量、手术时间、肛门排气时间、住院时间、复发率、阴囊水肿发生率、鞘膜积液发生率和两组精液参数改善率。结果研究组手术时间、手术切口、阴囊水肿发生率均显著低于对照组,比较差异具有统计学意义(P<0.05)。两组术中出血量、住院时间、肛门排气时间、精液参数改善率、鞘膜积液发生率、睾丸萎缩发生率和复发率,比较差异无统计学意义(P>0.05)。与术前相比,两组术后3个精液参数明显改善,比较差异具有统计学意义(P<0.05)。结论微切口经腹腔腹膜后精索静脉高位结扎术治疗精索静脉曲张的临床疗效肯定,值得临床推广。
Objective Firstly reported the clinical effect of transabdominal retroperitoneal spermatic vein high ligation through micro-incision in the treatment of cirsocele. Methods Sixty patients with left cirsocele treated in our hospital from January 2016 to December 2017 were selected as study subjects and randomly divided into study group and control group,with 30 cases in each group. In the study group,patients underwent transabdominal retroperitoneal spermatic vein high ligation through micro-incision,while those in the control group received inguinal spermatic vein high ligation. The amount of intraoperative bleeding,operation time,anal exhaust time,hospitalization time,recurrence rate,incidence of scrotal edema,incidence of hydrocele and improvement rate of sperm parameters in both groups were observed and compared.Results The operation time,surgical incision,incidence of scrotal edema in the study group was significantly lower than those in the control group,the difference was statistically significant( P< 0.05). The differences of amount of intraoperative bleeding,hospitalization time,anal exhaust time,improvement rate of sperm parameters,the incidence of hydrocele,the incidence and recurrence rate of testicular atrophy between the two groups was not statistically significant( P > 0.05).Compared with the preoperative parameters,the three semen parameters of the two groups were significantly improved,the differences were statistically significant( P < 0. 05). Conclusions The clinical efficacy of transabdominal retroperitoneal spermatic vein high ligation through micro-incision in the treatment of cirsocele was significant and it was worthy of clinical promotion.
Objective Firstly reported the clinical effect of transabdominal retroperitoneal spermatic vein high ligation through micro-incision in the treatment of cirsocele. Methods Sixty patients with left cirsocele treated in our hospital from January 2016 to December 2017 were selected as study subjects and randomly divided into study group and control group,with 30 cases in each group. In the study group,patients underwent transabdominal retroperitoneal spermatic vein high ligation through micro-incision,while those in the control group received inguinal spermatic vein high ligation. The amount of intraoperative bleeding,operation time,anal exhaust time,hospitalization time,recurrence rate,incidence of scrotal edema,incidence of hydrocele and improvement rate of sperm parameters in both groups were observed and compared.Results The operation time,surgical incision,incidence of scrotal edema in the study group was significantly lower than those in the control group,the difference was statistically significant( P< 0.05). The differences of amount of intraoperative bleeding,hospitalization time,anal exhaust time,improvement rate of sperm parameters,the incidence of hydrocele,the incidence and recurrence rate of testicular atrophy between the two groups was not statistically significant( P > 0.05).Compared with the preoperative parameters,the three semen parameters of the two groups were significantly improved,the differences were statistically significant( P < 0. 05). Conclusions The clinical efficacy of transabdominal retroperitoneal spermatic vein high ligation through micro-incision in the treatment of cirsocele was significant and it was worthy of clinical promotion.
引文
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[11]Zhang Z,Zheng SJ,Yu W,et al.Comparison of surgicaleffect and postoperative patient experience between aparoendoscopic singlesite and conventional laparos copic varicocelectomy:a systematic review and meta-analysis[J].Asia J Androl,2017,192(2):248-225.
[2]Sohrabvand F,Jafari M,Shariat M,et al.Frequency and epidemiologic aspects of male infertility[J].Acta Med Iran,2015,53(4):231-235.
[3]Shafi H,Esmaeilzadeh S,Delavar MA,et al.Prevalence of varicocele among primary and secondary infertile men:Association withoccupation,smoking and drinking alcohol[J].N Am J Med Sci,2014,6(10):532-535.
[4]Valentino M,Bertolotto M,Derchi L,et al.Children and adults varicocele:Diagnostic issues and therapeutical strategies[J].JUI-trasound,2014,17(3):185-193.
[5]Spinelli C,Strambi S,Busetto M,et al.Microsurgical inguinal varif cocelectomy in adolescents:delivered versus not delivered testis procedure[J].Can J Urol,2016,23(2):8254-825.
[6]Minutoli L.Arena S,Antonuccio P,et al.Role of inhibitors of apoptosis proteins in testicular function and male fertility:effects of polydeoxyribonucleotide administration in experimental varicocele[J].Biomed Res Int,2015,2015:248976.
[7]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南手册[M]北京:人民卫生出版社,2014:415-419.
[8]《精索静脉曲张诊断与治疗中国专家共识》编写组.精索静脉曲张诊断与治疗中国专家共识[J].中华男科学杂志,2015,21(11):1035-1042.
[9]杨波,林杨飞.不同术试治疗精索静脉曲张的临疗效比较[J].中国基层医,2016,23(7):1078-1079.
[10]李校,谢建军,邓君鹏,等.腹腔镜下保留精索内动脉的曲张静脉高位结扎术治疗精索静脉曲张(附42例报告)[J].中国男科学杂志,2016,30(7):34-37.
[11]Zhang Z,Zheng SJ,Yu W,et al.Comparison of surgicaleffect and postoperative patient experience between aparoendoscopic singlesite and conventional laparos copic varicocelectomy:a systematic review and meta-analysis[J].Asia J Androl,2017,192(2):248-225.