Zampieri Nicola, Zuin Veronica, Corroppolo Michele, Chironi Christian, Cervellione Raimondo Maximillian, Camoglio Francesco Saverio
Paediatric Surgical Unit, Policlinico "G. B. Rossi," Piazzale L.A. Scuro-37134, Verona, Italy.
J Androl. 2007 Sep-Oct;28(5):727-33. doi: 10.2164/jandrol.107.002600. Epub 2007 May 9.
The aim of this prospective study was to assess long-term functional results (spermiograms) in subjects who underwent laparoscopic varicocelectomy via either of 2 procedures (ligation or preservation of testicular artery). A total of 122 patients underwent laparoscopic varicocelectomy performed via either of the 2 different procedures: complete ligation of the spermatic vessels or preservation of the spermatic artery. After surgery when patients achieved 18 years, they were asked to undergo semen analysis. Spermiogram results were divided into 2 subgroups: "normal" and "abnormal." We analyzed volume, sperm count per mL, percentage of motile spermatozoa, percentage of normal spermatozoa, and percentage of vitality for each group. Both groups showed the same results in terms of "normal" and "abnormal" spermiograms (World Health Organization criteria), but analysis showed higher sperm concentration per mL, sperm motility, volume, vitality, and rate of morphologically normal sperm for the group with arteries preserved and "normal" spermiograms (P < .01). Analysis of data from the spermiograms showed that preservation of the testicular artery was the best possible option in terms of semen quality. Therefore, we believe that surgical treatment of varicocele should be carried out using procedures involving artery preservation.
这项前瞻性研究的目的是评估接受腹腔镜精索静脉高位结扎术的患者（采用两种手术方式之一：结扎或保留睾丸动脉）的长期功能结果（精液分析）。共有122例患者接受了通过两种不同手术方式之一进行的腹腔镜精索静脉高位结扎术：完全结扎精索血管或保留精索动脉。术后患者年满18岁时，要求他们进行精液分析。精液分析结果分为2个亚组：“正常”和“异常”。我们分析了每组的精液量、每毫升精子计数、活动精子百分比、正常精子百分比和活力百分比。两组在“正常”和“异常”精液分析（世界卫生组织标准）方面显示出相同的结果，但分析表明，保留动脉且精液分析为“正常”的组每毫升精子浓度、精子活力、精液量、活力和形态正常精子率更高（P<0.01）。精液分析数据表明，就精液质量而言，保留睾丸动脉是最佳选择。因此，我们认为精索静脉曲张的手术治疗应采用保留动脉的手术方式。
