腹腔镜超声下精索静脉高位结扎术效果

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (840 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the applicability of laparoscopic ultrasound technology in laparoscopic high ligation of the spermatic vein. Methods The preoperative and postoperative clinical data on 32 patients with bilateral varicoceles treated between October 2018 and October 2020 was analyzed retrospectively. These patients were aged 19 to 36, with an average age of (29.2±2.2) years old. The degree of varicoceles on both sides was Ⅱ～Ⅲ. B-ultrasound showed that the diameter of the varicoceles ranged from 2.2 to 4.6 cm. In twenty-three of these cases, the diameter of at least one varicocele was >3.0 cm. Complications with oligospermia were observed in thirteen of these cases. Preoperative examinations with color Doppler ultrasound ruled out the possibility of secondary varicoceles. Laparoscopic high ligation of both sides of the varicoceles was performed. Combined with laparoscopic ultrasound, a highly selective internal spermatic vein ligation was performed after the artery was preserved. Indicators related to the surgery and sperms, the relief rate of clinical symptoms, and postoperative complications were recorded. Results The surgery was a success for all the 32 patients without any severe bleeding or damage to the surrounding organs. The internal spermatic arteries on both sides were completely preserved in all these cases. In one case, bleeding occurred when one artery was separated, so cluster ligation was performed, leaving the patient with only one spermatic artery. The duration of surgery was (72.53±5.07) minutes while the hospital stay was (4.06±0.68) days. The patients were followed up for 6 months. The scrotal pain was relieved to different extents, and there was no recurrence or testicular atrophy. The preoperative sperm density of 13 patients with oligospermia was (14.38±1.26)×10⁶/ml, and the percentage of (a+b) grade sperms was (21.34±2.12)%, compared with (26.15±2.45)×10⁶/ml and (35.17±3.87)% six months after operation. Conclusions Laparoscopic high ligation of the spermatic vein combined with laparoscopic ultrasound in the treatment of bilateral varicoceles can effectively identify and preserve the internal spermatic arteries. Highly selective internal spermatic vein ligation can improve postoperative symptoms and semen quality.

Key words： varicocele laparoscopic varicocelectomy laparoscopic ultrasonography

Received: 16 June 2021

ZTFLH:

R697.24

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	MA Qiang
	YU Jiang
	MENG Mei
	WANG Li
	SUN Binghua
	YIN Zhaoyang
	SHEN Shanlin
	CUI Kai

Cite this article:

MA Qiang,YU Jiang,MENG Mei等. Applicability of laparoscopic ultrasonography in laparoscopic high ligation of varicoceles[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 969-972.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2021/V32/I11/969

[1]	中国医促会泌尿健康促进分会,中国研究型医院学会泌尿外科学专业委员会.精索静脉曲张手术治疗安全共识 [J].现代泌尿外科杂志, 2019, 24(6):429-433.
[2]	邓春华,商学军,姜辉,等.精索静脉曲张诊断与治疗中国专家共识[J].中华男科学杂志, 2015, 21(11): 1035-1042.
[3]	李泉,谢建军,邓君鹏,等.腹腔镜下保留精索内动脉的曲张静脉高位结扎术治疗精索静脉曲张(附42例报告)[J].中华男科学杂志, 2016,30(7): 34-37.
[4]	杨立杰,刘庆军.不同精索静脉曲张手术治疗精索静脉曲张的疗效对比[J].临床和实验医学杂志,2016,10(15): 1016-1020.
[5]	王晓利,王璟琦, 王东文,等.腹腔镜手术治疗精索静脉曲张的进展[J/CD].中华腔镜泌尿外科杂志(电子版), 2018, 12(2):139-141.
[6]	宋涛,王春阳,张磊,等.显微外科与腹腔镜两种手术治疗精索静脉曲张的疗效和并发症对比[J].中华男科学杂志, 2012,18(4):335-338.
[7]	刘健男,刘亚东,杨可来尔,等.精索静脉曲张外科治疗概述及有效性分析[J].现代泌尿外科杂志, 2018, 23(1):73-76.
[8]	陈方.青少年精索静脉曲张诊治中国小儿外科专家共识[J].中华小儿外科杂志, 2020,41(9):777-783.
[9]	王东,罗一钊,马志伟,等.经脐单孔腹腔镜技术治疗精索静脉曲张54例临床观察[J].西部医学, 2011, 23(10):1888-1890.
[10]	吕立群,李薇.双侧和单侧手术治疗左侧Ⅱ、Ⅲ度合并右侧亚临床或Ⅰ度精索静脉曲张不育男性疗效的Meta分析[J].中国性科学, 2017,26(6):110-113.
[11]	乔治,韩晨光,徐烨,等.部队官兵男性不育症诊疗现状及展望[J].武警医学, 2019,30(12):1099-1103.
[12]	陈汉民,钱彪,肖日海,等.经脐双通道腹腔镜与显微镜治疗双侧精索静脉曲张的疗效比较[J].现代泌尿外科杂志, 2020,25(5):412-414.
[13]	卫寿元,杨强,郑培,等.显微外科手术与腹腔镜手术治疗精索静脉曲张的疗效比较[J].安徽医药, 2019,23(8):1593-1596.
[14]	罗晟,张孝斌,程帆,等.开放和腹腔镜手术治疗精索静脉曲张的Meta分析[J].现代泌尿外科杂志, 2013,18(2):130-133.
[15]	李建友,陈鑫,王胜,等.腹腔镜精索静脉高选择性结扎术与腹腔镜精索静脉集束结扎术治疗精索静脉曲张临床疗效比较[J].中国性科学, 2017,26(4): 5-7.
[16]	Student V, Zatura F, Scheinar J, et al. Testicle hemodynamics in patients after 1 aparoscopic variclcectomy evaluated using color Doppler sonography[J]. Eur Urol, 1998, 33(1):91-93.
[17]	余伟民,阮远,饶婷,等.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[J/CD].中华腔镜泌尿外科杂志(电子版), 2016,10(5): 345-347.
[18]	周骏,梁朝朝,邰胜,等.腹腔镜超声在达芬奇机器人手术中的应用研究[J].微创泌尿外科杂志, 2018, 7(1): 1-5.