[显微镜下与腹腔镜精索静脉曲张切除术治疗精索静脉曲张：疗效与并发症]

[Microscopic versus laparoscopic varicocelectomy in the treatment of varicocele: effects and complications].

作者信息

Song Tao, Wang Chun-Yang, Zhang Lei, Zhang Fan, Chen Wen-Zheng, Fu Wei-Jun, Zhang Xu

机构信息

Department of Urology, General Hospital of Chinese PLA, Beijing 100853, China.

出版信息

Zhonghua Nan Ke Xue. 2012 Apr;18(4):335-8.

PMID:22574370

Abstract

OBJECTIVE

To compare the effects and postoperative complications of microscopic varicocelectomy (MV) and laparoscopic varicocelectomy (LV) in the treatment of varicocele.

METHODS

We assigned 72 varicocele patients to two groups of equal number to be treated by MV and LV. We compared the two groups in the semen parameters before and 3 months after surgery, postoperative complications, and pregnancy rates of the patients'wives.

RESULTS

The operative time was significantly longer in the MV than in the LV group (P<0.05). The postoperative hospital stay showed no significant difference between the MV and LV groups ([2.2 +/- 2.7] d vs [2.8 +/- 0.8] d). Sperm concentration, sperm motility and the percentage of grade a + b sperm were significantly increased in both groups after surgery (P<0.05), but with no significant differences between the two. The pregnancy rate was 65.2% in the former and 57.1% in the latter. Postoperative hydrocele occurred in 5 cases in the LV, but none in the MV group. There were no statistically significant differences in recurrence between the two groups (P>0.05).

CONCLUSION

MV is superior to LV for its minimal invasiveness, economical anesthesia, faster recovery and lower rates of postoperative complications and recurrence.

摘要

目的

比较显微镜下精索静脉结扎术（MV）与腹腔镜精索静脉结扎术（LV）治疗精索静脉曲张的效果及术后并发症。

方法

将72例精索静脉曲张患者平均分为两组，分别接受MV和LV治疗。比较两组患者手术前后的精液参数、术后并发症及患者配偶的妊娠率。

结果

MV组手术时间显著长于LV组（P<0.05）。MV组与LV组术后住院时间差异无统计学意义（[2.2±2.7]天对[2.8±0.8]天）。两组术后精子浓度、精子活力及a + b级精子百分比均显著升高（P<0.05），但两组间差异无统计学意义。前者妊娠率为65.2%，后者为57.1%。LV组有5例术后发生鞘膜积液，MV组无。两组复发率差异无统计学意义（P>0.05）。