腹腔镜下治疗精索静脉曲张的1年随访研究  

One-year follow-up study of laparoscopic treatment of varicocele

作　　者：宗焕涛[1] 刘璟芃 王涛[1] 周鑫[1] 周忠宝 张勇[1] 汪岩[2] Zong Huantao;Liu Jingpeng;Wang Tao;Zhou Xin;Zhou Zhongbao;Zhang Yong;Wang Yan(Department of Urology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Vascular Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,北京100070 [2]首都医科大学附属北京天坛医院血管外科,北京100070

出　　处：《血管与腔内血管外科杂志》2023年第11期1319-1322,共4页Journal of Vascular and Endovascular Surgery

基　　金：北京市医院管理中心“登峰”人才培养计划(DFL20190502)。

摘　　要：目的 探讨腹腔镜下高位结扎术治疗精索静脉曲张的远期疗效及安全性。方法 收集2020年3月至2022年5月于首都医科大学附属北京天坛医院接受腹腔镜下高位结扎术治疗的56例精索静脉曲张患者的临床资料。记录所有患者术前基本情况、手术相关信息、随访结果。主要终点是精索静脉曲张复发,次要终点是坠痛症状、配偶受孕情况和精液质量复查结果等。结果 56例患者中,有21例患者术前已婚不育。56例患者均成功实施腹腔镜下高位结扎术,手术时间为20~50 min,平均(37.4±5.1)min。出院时,症状消失51例,症状明显减轻5例;静脉曲张消失50例,静脉曲张明显缩小6例。住院期间,56例患者中无患者发生严重并发症。在术后1年的随访期间,症状消失53例(94.6%),仍偶有轻微坠胀、疼痛1例(1.8%),复发2例(3.6%);在21例术前不育的患者中,术后配偶受孕18例(85.7%)。21例患者术后3个月~1年复查精液质量均正常。结论 腹腔镜下高位结扎术治疗精索静脉曲张的远期疗效及安全性较好,值得临床推广。Objective To investigate the long-term efficacy and safety of laparoscopic high ligation in the treatment of varicocele.Method The clinical data of 56 patients with varicocele who underwent laparoscopic high ligation at Beijing Tiantan Hospital,Capital Medical University from March 2020 to May 2022 were collected.The basic preoperative conditions,surgery-related information,and follow-up results of all patients were recorded.The primary endpoint was the recurrence of varicocele,and the secondary endpoints were symptoms of penetrating pain,spouse's pregnancy status,and semen quality review results.Result Among the 56 patients,21 patients were married and infertile before surgery.Laparoscopic high ligation was successfully performed on all 56 patients.The operation time was 20 to 50 minutes,and the average operation time was(37.4±5.1)minutes.At discharge,symptoms disappeared in 51 cases and were significantly reduced in 5 cases;varicose veins disappeared in 50 cases and varicose veins were significantly reduced in 6 cases.During hospitalization,no serious complications occurred in any of the 56 patients.During the one-year follow-up period after surgery,symptoms disappeared in 53 cases(94.6%),while 1 case(1.8%)still had occasional slight swelling and pain,and 2 cases(3.6%)recurred.Among 21 patients with preoperative infertility,18 cases(85.7%)had their spouses become pregnant after the surgery.The semen quality of 21 patients was normal when reviewed three months to one year after the surgery.Conclusion Laparoscopic high ligation surgery that is worthy of clinical promotion,it has good long-term efficacy and safety in the treatment of varicocele.

关 键 词：腹腔镜 高位结扎术 精索静脉曲张 疗效 安全性 

分 类 号：R543[医药卫生—心血管疾病]