Erdas Enrico, Pisano Giuseppe, Pomata Mariano, Pinna Giovanni, Secci Lucia, Licheri Sergio, Daniele Giovanni Maria
Sezione di Chirurgia Generale II, Dipartimento di Scienze Chirurgiche e Trapianti d'Organo, Università degli Studi di Cagliari.
Chir Ital. 2006 Sep-Oct;58(5):619-25.
The purpose of this report was to compare two different procedures in the treatment of idiopathic hydrocele, namely, hydrocelectomy and percutaneous sclerotherapy, both of which performed in the outpatient or day surgery setting. A detailed description of the technical local anaesthesia steps is reported together with the sclerotherapy method. The study was conducted in 71 patients with a total of 77 hydroceles treated from 1993 to 2004. Surgery was carried out in 53 cases and sclerotherapy in 24. The latter was more frequently opted for elderly subjects as well as in those patients who requested it. Local or locoregional anaesthesia was reserved to patients treated surgically. The two treatments were compared on the basis of the following parameters: age, operative time, length of hospital stay, success rate and complications. The efficacy of the two procedures was comparable (sclerotherapy 95.8% vs surgery 100%), but sclerotherapy proved more favourable in terms of simplicity, rapidity of execution, shortness of hospital stay and risk of complications. However, 41.7% of patients required more than one treatment to obtain a radical cure, whereas surgery was effective in all cases in just one step. Hospital stay and morbidity were almost the same when surgery was performed under local anaesthesia. Sclerotherapy is an efficient alternative to the classic hydrocelectomy. The choice between the two treatment modalities should be made, taking into account above all the patient's individual preference.
本报告的目的是比较治疗特发性鞘膜积液的两种不同方法,即鞘膜切除术和经皮硬化疗法,这两种方法均在门诊或日间手术环境中进行。报告了局部麻醉技术步骤的详细描述以及硬化疗法。该研究纳入了1993年至2004年期间共77例鞘膜积液的71例患者。其中53例行手术治疗,24例行硬化疗法。后者在老年患者以及有此要求的患者中更常被选用。局部或区域麻醉仅用于接受手术治疗的患者。基于以下参数对两种治疗方法进行比较:年龄、手术时间、住院时间、成功率和并发症。两种方法的疗效相当(硬化疗法95.8% vs手术100%),但硬化疗法在操作简便性、执行速度、住院时间短和并发症风险方面更具优势。然而,41.7%的患者需要不止一次治疗才能获得根治,而手术在所有病例中一步即可有效。在局部麻醉下进行手术时,住院时间和发病率几乎相同。硬化疗法是经典鞘膜切除术的有效替代方法。在选择这两种治疗方式时,首先应考虑患者的个人偏好。