青少年腹腔镜精索静脉高位结扎术:选择性结扎或集束结扎  

Laparoscopic varicocelectomy in adolescent: cluster ligation or selective ligation

作　　者：余伟民[1] 阮远[1] 饶婷[1] 葛名欢[1] 李浩勇[1] 程帆[1] 张孝斌[1] 

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《中华腔镜泌尿外科杂志（电子版）》2016年第5期45-47,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨青少年腹腔镜下精索静脉高位结扎术中精索选择性动脉保留和集束结扎的疗效。方法 2010年1月至2013年12月,我院实施腹腔镜下精索静脉高位结扎术72例,术中轻柔地钝性分离精索内动脉并加以保留,动脉分离困难则只分离可识别的淋巴管,然后行集束结扎。记录两组手术时间,观察术后疗效。结果动脉保留31例,集束结扎41例。动脉保留组手术时间38.2 min,集束结扎组手术时间36.5 min,术后阴囊水肿两组各2例,动脉保留组1例复发,集束结扎组无复发,组间差异无统计学意义。术后1年,动脉保留组66.7%术前患侧萎缩的睾丸获得补偿性生长,集束结扎组为56.3%(P>0.05)。结论腹腔镜精索静脉集束结扎安全有效,对动脉保留困难的患者应及时施行集束结扎。Objective To explore the effects of laparoscopic varicocelectomy with cluster ligation and selective ligation in adolescent. Methods The total of 72 patients who underwent laparoscopic varicocelectomy was involved from January 2010 to December 2013 in our hospital. Slight blunt dissection was used to mobilize and preserve the artery. If the artery was not obvious, just separating the recognizable lymphatic vessels, and then cluster ligation was performed. Results All operations were successfully performed, arteries reserve in 31 cases, cluster ligation in 41 cases. The mean operative time was 38.2 min in artery reserve group, and 36.5 rain in cluster ligation group. Postoperative scrotal edema occur 2 cases in each group, one case recurrence in artery reserve group while none in cluster ligation group （P〉0.05）. One year later, 66.7% catch-up growth was detected in patients who suffered ipsilateral testis atrophy in artery reserve group, which was 56.3% in cluster ligation group （P〉0.05）. Conclmsion Laparoscopic varicocelectomy with cluster ligation is safe and effective, which should be timely ligate in patients whose artery was reserved difficultly.

关 键 词：腹腔镜 精索静脉曲张 结扎 青少年 

分 类 号：R699.8[医药卫生—泌尿科学]