Bilreiro C, Donato P, Costa J F, Agostinho A, Carvalheiro V, Caseiro-Alves F
Serviço de Imagem Médica, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal.
Serviço de Imagem Médica, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal.
Diagn Interv Imaging. 2017 Jul-Aug;98(7-8):529-534. doi: 10.1016/j.diii.2017.01.006. Epub 2017 Feb 6.
The purpose of this study was to compare metallic coils and glue (n-butyl-2 cyanoacrylate) for varicocele embolization, regarding immediate technical and clinical success, procedure time, complications and recurrence rates.
A retrospective analysis of a consecutive series of varicocele embolization procedures performed between July 2012 and July 2015 was undertaken. A total of 129 procedures were performed, 26 using glue (20.2%; 26 men with a mean age of 32.6 years) and 103 using coils (79.8%; 103 men with a mean age of 32.3 years). Demographic data, indications, technique, procedure time, complications and outcomes were compared.
A total of 89 procedures (69%) were motivated by infertility (glue=20, coils=69) and 40 (31%) by testicular pain (glue=6, coils=34). The mean procedure time was 35.58±13.44 (SD) min for glue and 45.97±17.46 (SD) min for coils (P=0.0054). Immediate technical success rate was 100% using glue and 99% using coils (P=1.0000). A single minor complication was observed after coil embolization (0.97%). Both materials showed significant improvement of semen parameters, with similar clinical success rates. For patients referred for testicular pain, clinical success rate was 66.67% using glue and 88.24% using coils (P=0.2147). Recurrence rate was 11.54% with glue and 5.83% with coils (P=0.4000). Procedure time was significantly shorter with glue (P=0.0054).
Glue and coils are both safe and effective for varicocele embolization. However, the use of glue yields shorter procedure time.
本研究旨在比较金属线圈和胶水（正丁基-2-氰基丙烯酸酯）用于精索静脉曲张栓塞术的即时技术成功率、临床成功率、手术时间、并发症及复发率。
对2012年7月至2015年7月间连续进行的一系列精索静脉曲张栓塞术进行回顾性分析。共进行了129例手术，其中26例使用胶水（20.2%；26名男性，平均年龄32.6岁），103例使用线圈（79.8%；103名男性，平均年龄32.3岁）。比较了人口统计学数据、适应证、技术、手术时间、并发症及结果。
共有89例手术（69%）因不育而进行（胶水组20例，线圈组69例），40例（31%）因睾丸疼痛而进行（胶水组6例，线圈组34例）。胶水组的平均手术时间为35.58±13.44（标准差）分钟，线圈组为45.97±17.46（标准差）分钟（P=0.0054）。胶水的即时技术成功率为100%，线圈为99%（P=1.0000）。线圈栓塞术后观察到1例轻微并发症（0.97%）。两种材料均使精液参数有显著改善，临床成功率相似。对于因睾丸疼痛而转诊的患者，胶水的临床成功率为66.67%，线圈为88.24%（P=0.2147）。胶水的复发率为11.54%，线圈为5.83%（P=0.4000）。胶水的手术时间明显更短（P=0.0054）。
胶水和线圈用于精索静脉曲张栓塞术均安全有效。然而，使用胶水可使手术时间更短。
