Bebars G A, Zaki A, Dawood A R, El-Gohary M A
General Surgery Department, Mafraq Hospital, Abu Dhabi, United Arab Emirates.
JSLS. 2000 Jul-Sep;4(3):209-13.
The purpose of this study is to determine the relative advantages of laparoscopic varicocelectomy compared to the conventional open high ligation of Palomo. We studied 193 patients who presented with varicocele. While 65 patients were treated by open high ligation of the testicular veins, 128 patients had laparoscopic varicocelectomy. In addition to varicocele ligation, 14 patients (11%) had laparoscopy-assisted right orchidopexy, and 5 patients (4%) had laparoscopic repair of concomitant right inguinal hernia. The mean hospital stay was 3.5 days and 1.3 days, respectively, and the recurrence rates were 10.8% and 3.9%, respectively. Return to normal activity was significantly earlier in Group II (mean 4.5 days) compared to Group I (mean 8.9 days). There was no incidence of testicular atrophy in any case in the study, regardless of whether the testicular artery was ligated or preserved during surgery. We conclude that laparoscopic varicocelectomy is safe, effective and minimally invasive. In addition to its better cosmetic results and advantage in case of bilateral disease, it allows excellent exposure and control of the affected vessels. Furthermore, the shorter hospital stay and the earlier return to normal activities are very important advantages in recommending this technique as an efficient alternative to the open surgical method.
本研究的目的是确定腹腔镜精索静脉结扎术相较于传统开放式Palomo高位结扎术的相对优势。我们研究了193例精索静脉曲张患者。其中65例患者接受了开放式睾丸静脉高位结扎术，128例患者接受了腹腔镜精索静脉结扎术。除精索静脉曲张结扎外，14例患者（11%）接受了腹腔镜辅助下右侧睾丸固定术，5例患者（4%）接受了腹腔镜下右侧腹股沟疝修补术。平均住院时间分别为3.5天和1.3天，复发率分别为10.8%和3.9%。与第一组（平均8.9天）相比，第二组（平均4.5天）恢复正常活动的时间明显更早。在本研究中，无论手术中睾丸动脉是被结扎还是保留，均未发生睾丸萎缩的情况。我们得出结论，腹腔镜精索静脉结扎术安全、有效且微创。除了其更好的美容效果以及在双侧疾病情况下的优势外，它还能很好地暴露和控制受累血管。此外，较短的住院时间和更早恢复正常活动是推荐该技术作为开放式手术方法的有效替代方案的非常重要的优势。
