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目的探讨经腹股沟切口显微精索静脉结扎术与传统经腹股沟、腹腔镜技术精索静脉结扎术的安全性。方法回顾性分析自2005年6月至2006年12月间收治的118例精索静脉曲张患者(156侧)3种不同术式术后并发症的发生率,其中60例采用经腹股沟途径显微技术,40例采用传统经腹股沟技术,18例采用腹腔镜精索静脉结扎术。随访时间6～12个月。结果显微技术、传统经腹股沟途径、腹腔镜技术精索静脉结扎术后阴囊水肿发生率分别为0%(0/76)、6%(3/50)、3.4%(1/30);复发率分别为1.67%(1/76)、7.5%(4/50)、6.7%(2/30),三组均未见睾丸萎缩。经统计学分析,显微技术阴囊水肿发生率低于另外两组(P<0.05)。复发率及睾丸萎缩发生率在三组间无统计学差异。结论较传统经腹股沟途径和腹腔镜技术精索静脉结扎术,经腹股沟途径显微技术未发生术后阴囊水肿,曲张复发率低,是一种值得推广的安全术式。
Objective To investigate the safety of transvaginal stenosis by microsurgical varicocele and conventional transvaginal and laparoscopic varicocele ligation. Methods The incidence of postoperative complications in 118 patients with varicocele (156 sides) who were admitted to our hospital from June 2005 to December 2006 was retrospectively analyzed. Among them, 60 cases were treated by the inguinal approach Technique, 40 patients underwent traditional inguinal technique and 18 patients underwent laparoscopic spermatic vein ligation. Follow-up time of 6 to 12 months. Results The incidences of scrotal edema were 0% (0/76), 6% (3/50) and 3.4% (1/30) respectively after microsurgical and conventional transvaginal approach and laparoscopic spermatic vein ligation. Recurrence Rates were 1.67% (1/76), 7.5% (4/50), 6.7% (2/30) respectively. No testicular atrophy was found in the three groups. After statistical analysis, the incidence of microscopic scrotal edema was lower than the other two groups (P <0.05). The recurrence rate and the incidence of testicular atrophy were not statistically different among the three groups. Conclusion Compared with traditional method of transvaginal groin and laparoscopic varicocele ligation, there is no postoperative scrotal edema and low recurrence rate of varicosity through the inguinal approach microscopy, which is a safe surgical procedure worthy of promotion.