Clarke S A, Agrawal M, Reidy J
Department of Paediatric Surgery, University Hospital Lewisham, London, UK.
Pediatr Radiol. 2001 Jul;31(7):515-7. doi: 10.1007/s002470000418.
Controversy surrounds the early treatment of childhood varicocoele and its role in the prevention of testicular atrophy and male infertility. Various techniques exist, all with varying degrees of success.
To show that percutaneous transfemoral testicular vein embolisation is an effective alternative when compared to the conventional open surgical approach.
A retrospective review examining 48 boys (aged 9-18 years; mean 13.2 years) who were treated with transcatheter testicular vein embolisation between 1985 and 1999. Follow-up took the form of out-patient clinical assessment and a telephone questionnaire. Patients were graded as 'good', 'moderate' or 'poor', according to various criteria.
Of the 48 patients, 43 (90%) had satisfactory embolisations. Thirty-eight (88 %) had a 'good' clinical outcome at follow-up. There were five technical failures due to a combination of abnormal venous anatomy and severe venospasm.
We believe that where the expertise necessary for testicular embolisation is available, it should be offered as the intervention of first choice. Surgery should be reserved for the rare cases where embolisation is not possible or when recurrence has occurred.
儿童精索静脉曲张的早期治疗及其在预防睾丸萎缩和男性不育症中的作用存在争议。现有多种技术，但其成功率各不相同。
旨在表明与传统的开放手术方法相比，经皮经股睾丸静脉栓塞术是一种有效的替代方法。
对1985年至1999年间接受经导管睾丸静脉栓塞术治疗的48名男孩（年龄9至18岁；平均13.2岁）进行回顾性研究。随访采用门诊临床评估和电话问卷调查的形式。根据各种标准将患者分为“良好”、“中等”或“差”。
48例患者中，43例（90%）栓塞效果满意。38例（88%）在随访时临床结果为“良好”。由于静脉解剖结构异常和严重静脉痉挛，有5例技术失败。
我们认为，在具备睾丸栓塞所需专业知识的情况下，应将其作为首选干预措施。手术应保留给栓塞不可能进行或复发的罕见病例。
