Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada.
Urology. 2010 Jun;75(6):1324-7. doi: 10.1016/j.urology.2009.11.033. Epub 2010 Feb 25.
To examine and compare the left and right spermatic cord arterial and lymphatic anatomy identified at primary and redo microsurgical subinguinal varicocelectomy.
We reviewed the operative reports of 335 consecutive microsurgical varicocelectomies performed by a single surgeon: 325 primary repairs and 10 reoperations. We recorded number of testicular arteries (internal and external spermatic) and lymphatic channels preserved at subinguinal microsurgical varicocelectomy, and evaluated the relationship between the right and left vascular anatomy at bilateral varicocelectomy.
A total of 235 left-sided and 90 bilateral primary repairs were performed. A mean (+/-standard deviation) number of 2.4+/-1.0 arteries and 4.6+/-1.5 lymphatics were identified during the left-sided repairs. For bilateral repairs, there were 2.4+/-0.9 arteries and 4.4+/-1.2 lymphatics on the left and 2.2+/-0.9 arteries and 4.2+/-1.3 lymphatics on the right with a significant correlation between the number of right and left internal spermatic arteries (r=0.42). For the cohort of secondary (redo) varicocelectomies, we identified 2.3+/-0.6 arteries and 4.8+/-1.6 lymphatic channels (not significantly different from the primary varicocelectomy cohorts).
The number of arteries and lymphatics preserved at microsurgical varicocelectomy is highly variable, but there is some similarity in the microanatomy of the right and left spermatic cords at the level of the external inguinal ring. The data also suggest that the number of arteries and lymphatic channels identified at a redo varicocelectomy is comparable to that observed during a primary varicocelectomy.
研究并比较初次和再次经显微外科腹股沟下精索静脉结扎术时，左右精索动脉和淋巴管的解剖结构。
我们回顾了一位外科医生进行的 335 例连续显微精索静脉结扎术的手术报告：325 例初次修复和 10 例再次手术。我们记录了在腹股沟下精索静脉结扎术中保留的睾丸动脉（内部和外部精索）和淋巴管的数量，并评估了双侧精索静脉结扎术时左右血管解剖结构的关系。
共进行了 235 例左侧和 90 例双侧初次修复。左侧修复中平均（+/-标准差）识别出 2.4+/-1.0 条动脉和 4.6+/-1.5 条淋巴管。对于双侧修复，左侧有 2.4+/-0.9 条动脉和 4.4+/-1.2 条淋巴管，右侧有 2.2+/-0.9 条动脉和 4.2+/-1.3 条淋巴管，右侧和左侧内部精索动脉数量之间存在显著相关性（r=0.42）。对于二次（再次）精索静脉结扎术的队列，我们识别出 2.3+/-0.6 条动脉和 4.8+/-1.6 条淋巴管（与初次精索静脉结扎术队列无显著差异）。
在显微精索静脉结扎术中保留的动脉和淋巴管数量变化很大，但在腹股沟外环水平的左右精索的微观解剖结构中存在一定的相似性。数据还表明，在再次精索静脉结扎术中识别的动脉和淋巴管数量与初次精索静脉结扎术观察到的数量相当。
