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中国男性腹股沟下显微外科精索静脉结扎术中的精索静脉曲张解剖结构

Varicocele anatomy during subinguinal microsurgical varicocelectomy in Chinese men.

作者信息

Lv K-L, Zhuang J-T, Zhao L, Wan Z, Zhang Y-D, Gao Y, Sun X-Z, Qiu S-P, Deng C-H, Tu X-A

机构信息

Department of Urology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

出版信息

Andrologia. 2015 Dec;47(10):1190-5. doi: 10.1111/and.12402. Epub 2015 Feb 3.

Abstract

Knowledge of subinguinal microsurgical varicocelectomy is of fundamental importance to ensure that varicocele is resolved and testicular function is preserved. Our study aimed to describe the number of veins, arteries and lymphatics in the subinguinal spermatic cord and to clarify their differences between two sides, between patients with different complaints and between varicoceles with different clinical grades. A total of 102 consecutive patients underwent 162 primary subinguinal microsurgical varicocelectomies, during which the number of vessels with different diameters was recorded. A mean number of 12.9 internal spermatic veins, 0.9 external spermatic veins, 1.8 internal spermatic arteries and 2.9 lymphatics were identified per cord. 88.2% of the internal spermatic arteries were surrounded by a dense complex of adherent veins. The external spermatic vein or veins were found in 49.4% of the cases. The mean number of medium (1-3 mm in diameter) internal spermatic veins on the left was larger than that on the right (P < 0.001). The mean number of medium internal spermatic veins in grade III varicocele was larger than that in grade I or grade II (P < 0.015). There was no significant anatomical difference between the men presenting for infertility, chronic testicular pain and both the two complaints.

摘要

了解腹股沟下显微外科精索静脉曲张切除术对于确保精索静脉曲张得到解决并保留睾丸功能至关重要。我们的研究旨在描述腹股沟下精索内静脉、动脉和淋巴管的数量,并阐明两侧之间、不同主诉患者之间以及不同临床分级的精索静脉曲张之间的差异。共有102例连续患者接受了162例原发性腹股沟下显微外科精索静脉曲张切除术,术中记录了不同直径血管的数量。每条精索内平均发现12.9条精索内静脉、0.9条精索外静脉、1.8条精索内动脉和2.9条淋巴管。88.2%的精索内动脉被密集的粘连静脉复合体包围。49.4%的病例发现有一条或多条精索外静脉。左侧中等直径(1-3毫米)精索内静脉的平均数量多于右侧(P<0.001)。III级精索静脉曲张中中等直径精索内静脉的平均数量多于I级或II级(P<0.015)。因不育、慢性睾丸疼痛就诊的男性以及同时有这两种主诉的男性之间在解剖学上没有显著差异。

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