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微创与传统鞘膜积液切除术:一项随机试验。

Minimally access versus conventional hydrocelectomy: a randomized trial.

作者信息

Saber Aly

机构信息

Department of General Surgery, Port-Fouad general Hospital, Port-Fouad, Egypt.

出版信息

Int Braz J Urol. 2015 Jul-Aug;41(4):750-6. doi: 10.1590/S1677-5538.IBJU.2014.0248.

Abstract

OBJECTIVE

To compare our previously published new minimally access hydrocelectomy versus Jaboulay's procedure regarding operative outcome and patient's satisfaction.

MATERIALS AND METHODS

A total of 124 adult patients were divided into two groups: A and B. Group A patients were subjected to conventional surgical hydrocelectomy (Jaboulay's procedure) and group B patients were subjected to the new minimal access hydrocelectomy. The primary endpoint of the study was recurrence defined as a clinically detectable characteristic swelling in the scrotum and diagnosed by the two surgeons and confirmed by ultrasound imaging study. The secondary endpoints were postoperative hematoma, wound sepsis and persistent edema and hardening.

RESULTS

The mean operative time in group B was 15.1 ± 4.24 minutes and in group A was 32.5 ± 4.76 minutes (P ≤ 0.02). The mean time to return to work was 8.5 ± 2.1 (7-10) days in group B while in group A was 12.5 ± 3.53 (10-15) days (P=0.0001). The overall complication rate in group B was 12.88% and in group A was 37%. The parameters of the study were postoperative hematoma, degree of scrotal edema, wound infection, patients' satisfaction and recurrence.

CONCLUSION

Hydrocelectomy is considered the gold standard technique for the treatment of hydrocele and the minimally access maneuvers provide the best operative outcomes regarding scrotal edema and hardening and patient's satisfaction when compared to conventional eversion-excision hydrocelectomies.

摘要

目的

比较我们之前发表的新型微创鞘膜积液切除术与贾布莱手术的手术效果及患者满意度。

材料与方法

124例成年患者被分为两组:A组和B组。A组患者接受传统手术鞘膜积液切除术(贾布莱手术),B组患者接受新型微创鞘膜积液切除术。该研究的主要终点是复发,定义为阴囊内临床上可检测到的特征性肿胀,由两位外科医生诊断并经超声影像学检查确认。次要终点是术后血肿、伤口感染和持续性水肿及硬结。

结果

B组平均手术时间为15.1±4.24分钟,A组为32.5±4.76分钟(P≤0.02)。B组平均恢复工作时间为8.5±2.1(7 - 10)天,A组为12.5±3.53(10 - 15)天(P = 0.0001)。B组总体并发症发生率为12.88%,A组为37%。研究参数包括术后血肿、阴囊水肿程度、伤口感染、患者满意度和复发情况。

结论

鞘膜积液切除术被认为是治疗鞘膜积液的金标准技术,与传统外翻切除鞘膜积液切除术相比,微创手术在阴囊水肿和硬结以及患者满意度方面提供了最佳的手术效果。

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