Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Int J Surg. 2015 Jun;18:178-83. doi: 10.1016/j.ijsu.2015.04.048. Epub 2015 May 1.
Varicocele is the most common correctable cause of infertility. We analyzed the outcomes of single incision laparoscopic varicocelectomy (SIL-V) in comparison with conventional transperitoneal varicocelectomy (CTL-V).
Patients with clinically palpable varicocele treated by laparoscopic varicocelectomy were randomly allocated into two groups: SIL-V and CTL-V group. The primary outcome measures were improvement in semen parameters and resolution of testicular pain. Secondary outcome measures included operating time, postoperative pain scores, time to return to normal activity, patient satisfaction and postoperative complications.
Eighty patients completed the study. No vascular or intestinal complications occurred during both procedures. All patients were discharged 24 h postoperatively. The parameters measuring the success of varicocelectomy had improved for the majority of patients with no significant difference between the two groups. There was significantly longer operating time in SIL-V group (44.6 ± 5.4 min) than in CTL-V group (41.3 ± 8.5 min) (P = 0.03). The difference in operating time was lost when bilateral procedures were compared (P = 0.21). The mean VAS scores for pain at 3, 24 and 48 h postoperatively were significantly lower in SIL-V group (P = 0.02, P = 0.03 and P < 0.001 respectively). Time to return to normal activity was significantly shorter in SIL-V (P < 0.001). Patient satisfaction was significantly higher in SIL-V group (P < 0.01). Postoperative complications were comparable in both groups.
SIL-V is a safe and effective straightforward alternative to the well-established and accepted CTL-V. The tendency toward decreased postoperative pain, rapid return to normal activity and the high patients' satisfaction rate regarding cosmetic results are potential benefits of SIL-V procedure.
(NCT02335385).
精索静脉曲张是最常见的可纠正的不育原因。我们分析了单切口腹腔镜精索静脉结扎术（SIL-V）与传统经腹腔精索静脉结扎术（CTL-V）的结果。
对接受腹腔镜精索静脉结扎术治疗的临床可触及精索静脉曲张患者进行随机分组，分为 SIL-V 组和 CTL-V 组。主要观察指标是精液参数的改善和睾丸疼痛的缓解。次要观察指标包括手术时间、术后疼痛评分、恢复正常活动的时间、患者满意度和术后并发症。
80 例患者完成了研究。两种手术均未发生血管或肠道并发症。所有患者均在术后 24 小时出院。大多数患者的精索静脉结扎术成功指标均有所改善，两组之间无显著差异。SIL-V 组的手术时间明显长于 CTL-V 组（44.6 ± 5.4 分钟比 41.3 ± 8.5 分钟）（P = 0.03）。当比较双侧手术时，手术时间的差异消失（P = 0.21）。SIL-V 组术后 3、24 和 48 小时的平均 VAS 疼痛评分明显较低（P = 0.02、P = 0.03 和 P < 0.001）。SIL-V 组恢复正常活动的时间明显缩短（P < 0.001）。SIL-V 组患者满意度明显较高（P < 0.01）。两组术后并发症相当。
SIL-V 是一种安全有效的替代方法，与成熟且公认的 CTL-V 相比具有潜在优势。SIL-V 术后疼痛减轻、快速恢复正常活动和患者对美容效果的高满意度是潜在的获益。
（NCT02335385）。
