Medical Research Institute of Pusan National University, Busan, Korea.
Int J Urol. 2011 Mar;18(3):250-4. doi: 10.1111/j.1442-2042.2010.02701.x. Epub 2011 Jan 10.
We aimed to determine the efficacy of umbilical laparoendoscopic single site surgery (LESS) bilateral varicocelectomy on the basis of a comparative study versus open inguinal bilateral varicocelectomy. We enrolled 39 patients who underwent bilateral varicocelectomy with predetermined surgical indications at two hospitals with either the LESS (n = 19) or the open inguinal approach (n = 20). Operative time, operation-related pain (10-point visual analog pain scale), catch-up growth of the testes, semen parameters, and complications after surgery between the LESS group and the open group at 3 months after surgery were compared. Operative times were 46.8 and 72.8 min (P < 0.001) in the LESS and open surgery groups, respectively. Patients in the LESS group reported lower surgery-related pain than those in the open surgery group at 3 months (2.5 vs 1.2, P = 0.029). A significant improvement in terms of semen concentration, motility, catch-up growth of the bilateral testes was observed in both groups, although no significant differences were detected between the groups. Postoperative complications were also similar between the two groups. LESS varicocelectomy required a shorter operative time than inguinal varicocelectomy for bilateral cases. In addition, the LESS procedure showed less postoperative pain and cosmetic benefits with similar seminal outcomes. Thus, LESS for patients undergoing bilateral varicocelectomy represents a promising surgical approach.
我们旨在通过与开放腹股沟双侧精索静脉曲张切除术的对比研究，确定脐腹腔镜单部位手术（LESS）双侧精索静脉曲张的疗效。我们招募了 39 名在两家医院因预定手术指征而接受双侧精索静脉曲张切除术的患者，其中 LESS 组（n=19）和开放腹股沟组（n=20）各 19 名。比较 LESS 组和开放组术后 3 个月的手术时间、与手术相关的疼痛（10 分视觉模拟疼痛量表）、睾丸追赶生长、精液参数和术后并发症。LESS 组和开放组的手术时间分别为 46.8 和 72.8 分钟（P<0.001）。LESS 组患者术后 3 个月与手术相关的疼痛明显低于开放手术组（2.5 对 1.2，P=0.029）。两组的精液浓度、活力和双侧睾丸追赶生长均有显著改善，但组间无显著差异。两组术后并发症也相似。LESS 精索静脉曲张切除术双侧病例的手术时间比腹股沟精索静脉曲张切除术短。此外，LESS 手术具有术后疼痛较轻、美容效果较好的优点，精液结果相似。因此，LESS 治疗双侧精索静脉曲张患者是一种有前途的手术方法。
