标题:
腹腔镜与显微镜下治疗青年精索静脉曲张疗效分析Comparison of the Outcomes of Laparoscopic Varicocelectomy and Microscopic Varicocelectomy in Adolescence
作者:
孙广海, 刘萃龙, 吴意光, 赵豫波, 徐衍盛, 周茂军, 王毅, 王希友, 关维民
关键字:
青年, 精索静脉曲张, 精液质量, 腹腔镜, 显微镜, 慢性前列腺炎Adolescence, Varicocele, Semen Quality, Laparoscopy, Microscopy, Chronic Prostatitis
期刊名称:
《Hans Journal of Surgery》, Vol.4 No.2, 2015-04-20
摘要:
目的：探讨腹腔镜与显微镜下治疗青年原发性精索静脉曲张的疗效、安全性。方法：回顾性分析71名青年原发性精索静脉曲张患者治疗后随访资料，其中有5例慢性前列腺炎患者。39例接受腹腔镜精索静脉高位结扎术(腹腔镜组)，2例慢性前列腺炎患者；32例接受显微镜下精索静脉结扎组(显微镜组)，3例慢性前列腺炎患者。比较两组患者术前、术后3月精液质量、激素水平、睾丸体积变化情况及手术时间、住院天数、费用。结果：两组患者手术均顺利完成，腹腔镜组与显微镜组相比手术时间明显缩短(85.94 ± 20.44 vs 39.00 ± 9.69, P 0.05)。两组患者术后精液质量较术前无差异(P > 0.05)，精子密度、精子存活率、A + B级精子明显改善，差异有统计学意义(P 0.05)。腹腔镜组术后2例(5.1%)复发，1例(2.6%)附睾炎，2例(5.1%)症状持续存在，2例(5.1%)阴囊水肿；显微镜组术后无复发、附睾炎、阴囊水肿，但是有1例(3.1%)患者症状持续存在。结论：青年精索静脉曲张患者精液质量大多已受影响，早期手术可以恢复精液质量或减轻精液质量的下降。腹腔镜与显微镜下治疗精索静脉曲张均为微创手术，创伤小、疗效好，但是显微镜下治疗精索静脉曲张费用低、术后复发率低、并发症更少。Objective: To compare curative effect between microscopic and laparoscopic approach for treatment of varicocele. Method: We retrospectively analyzed 71 adolescence varicocele patients after treatment follow-up data. 39 cases underwent laparoscopic high ligation of spermatic vein (laparoscopic group). 32 patients received ligation of varicocele group under the microscope (microscopy group). The semen quality, hormone levels and testicular volumes of these two groups of patients before and after the operation, operation time, hospitalization days and cost were compared. Results: All patients were successfully completed the operation. Laparoscopic group compared with microscope group operation time is obviously shortened (85.94 + 20.44VS39.00 + 9.69, P 0.05), but the cost was significantly increased (4866 + 541.45VS7820 + 906.21, P