腹腔镜精索静脉曲张高位结扎日间手术的可行性及安全性分析  

Feasibility and safety of ambulatory surgery for laparoscopic high ligation of varicocele

作　　者：王晓明[1] 白云金 韩平[1] 杨玉帛 李金洪[1] 唐寅[1] 魏强[1] 

机构地区：[1]四川大学华西医院泌尿外科/泌尿外科研究所,四川成都610041

出　　处：《现代泌尿外科杂志》2017年第3期169-172,共4页Journal of Modern Urology

基　　金：国家自然科学基金(No.81270841);四川省科技厅科技支撑计划(No.2013SZ0034)

摘　　要：目的探讨腹腔镜精索静脉曲张高位结扎日间手术模式的可行性与安全性。方法回顾性分析2012年3月至2015年4月接受腹腔镜精索静脉高位结扎术治疗的精索静脉曲张患者306例的临床资料。日间手术组153例,住院手术组153例。比较两组患者的等待入院时间、手术时间、住院时间、手术费用、术后复发率、鞘膜积液发生率、精液质量改善率及配偶自然怀孕率。结果日间手术组与住院手术组手术时间、术后复发率、鞘膜积液发生率、精液质量改善率及配偶自然怀孕率差异均无统计学意义(P>0.05)。日间手术组平均等待入院时间为(4.29±1.68)d,显著短于住院组的(8.41±2.59)d(P<0.05)。住院手术组人均费用为(7 972.97±3 906.07)元,日间手术组人均费用为(6 206.06±1 177.54)元,差异有显著性统计学意义(P<0.05)。结论日间手术模式能显著减少精索静脉曲张患者的等待入院时间、住院时间及住院费用,严格的入院筛选、术前准备及术后观察随访保证了日间手术的安全性及可行性。Objective To explore the feasibility, advantages and safety of ambulatory surgery for laparoscopic high ligation of varicocele. Methods A retrospective study was conducted on all patients with ASA Ⅰ - Ⅱ , who had laparoscopic varicocelectomy during Mar. 2012 and Apr. 2015. The patients were divided into 2 groups： ambulatory group （n- 153） and conventional group （n=153）. The effectiveness was analyzed by evaluating the time waiting to be admitted, operation time, complications, hospitalization costs, in-hospital days, postoperative recurrence rate, postoperative incidence of hydrocele, semen quality improvement rate and spontaneous pregnancy rate. Results There were no significant differences in the mean operation time, postoperative recurrence rate, and postoperative incidence of hydrocele between the two groups （P〉0.05）. The mean time waiting to be admitted of the ambulatory group was statistically shorter than that of conventional group. Patients in the ambulatory group spent statistically less money than patients in the conventional group （￥6 206.04 vs. ￥ 7 972.97, P〈0.05）. Conclusions Ambulatory laparoscopic varicocelectomy is as effective and safe as hospital based laparoscopic varicocelectomy, with a good level of perceived quality.

关 键 词：日间手术 腹腔镜 精索静脉曲张 可行性 

分 类 号：R699.1[医药卫生—泌尿科学]