Arvind Nand Kishore, Singh Onkar, Gupta Shilpi Singh
Department of Urology, Bhopal Memorial Hospital & Research Centre, Bhopal, India.
JSLS. 2011 Oct-Dec;15(4):580-4. doi: 10.4293/108680811X13176785204797.
Testicular vein syndrome (TVS) is a rare cause of ureteral obstruction. Only 5 previous cases are on record in the literature, and no review exists on this topic to date. Laparoscopic treatment has never been mentioned in the management of TVS.
We reviewed the literature related to this unusual entity to clarify the preoperative evaluation and the management of TVS. For this purpose, the data related to all the 5 cases previously reported so far in the English literature have been reviewed. Also, we report the sixth case of TVS, and the first patient to be successfully treated with the laparoscopic approach. This was a 37-year-old male with a 6-month history of left loin pain. Preoperative diagnosis was confirmed by CT-Urography.
Our patient underwent laparoscopic excision of the left testicular vein followed by ureteroureterostomy in a single sitting. The laparoscopic transperitoneal approach was used. Histopathological examination of the vein showed normal venous tissue. This is the sixth reported case of TVS and the first to be successfully treated with a laparoscopic technique.
A laparoscopic approach is safe and effective for treating patients with TVS with the common advantages of minimal invasiveness and better visualization of the complex anatomy of the retroperitoneum. Thus, it should be the treatment of choice for TVS.
睾丸静脉综合征（TVS）是输尿管梗阻的罕见病因。文献中仅记录了5例既往病例，迄今为止尚无关于该主题的综述。腹腔镜治疗在TVS的管理中从未被提及。
我们回顾了与这个不寻常实体相关的文献，以阐明TVS的术前评估和管理。为此，对英文文献中迄今为止报道的所有5例病例的数据进行了回顾。此外，我们报告了第6例TVS病例，也是首例通过腹腔镜方法成功治疗的患者。这是一名37岁男性，有6个月的左腰部疼痛病史。术前诊断通过CT尿路造影得以证实。
我们的患者在一次手术中接受了腹腔镜下左睾丸静脉切除术，随后进行了输尿管输尿管吻合术。采用了腹腔镜经腹途径。静脉的组织病理学检查显示静脉组织正常。这是第6例报道的TVS病例，也是首例通过腹腔镜技术成功治疗的病例。
腹腔镜方法对于治疗TVS患者是安全有效的，具有微创性和能更好地观察腹膜后复杂解剖结构的共同优点。因此，它应该是TVS的首选治疗方法。
