Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Sci Rep. 2018 Jul 12;8(1):10534. doi: 10.1038/s41598-018-28887-9.
The recurrence rates after varicocelectomy vary from 0.9% to 32.2%, especially for patients with the left renal vein entrapment (LRVE). This study aims to study the association between LRVE and varicocele recurrence, and to find the risk factors of LRVE. With the design of a cohort study, we included 3042 varicocele patients who would undergo modified inguinal microscope-assisted varicocelectomy (MHMV). 858 (28.21%) patients with LRVE were as the study group, and 2184 (71.79%) patients without LRVE were as the control group. Compared with the control group, BMI was lower (p < 0.001) in study group. Totally, 18 patients had recurrence after surgery, so the recurrence rate was 0.59%. Seventeen patients (1.98%) in study group and 1 patients (0.05%) in control group had recurrence, and significant statistical difference was found between the two groups (p < 0.001). The risk ratio of LRVE for varicocele recurrence is 43.27. In conclusion, the recurrence rate of our MHMV is the lowest (0.59%). There is association between LRVE and varicocele recurrence, and varicocele patients with LRVE have higher probability of recurrence rate after varicocelectomy. BMI could be a risk factor of LRVE. Thus, for varicocele patients, especially those with lower BMI, attentions should be payed to LRVE.
精索静脉曲张手术后的复发率为 0.9%至 32.2%，尤其是对于左侧肾静脉压迫（LRVE）的患者。本研究旨在探讨 LRVE 与精索静脉曲张复发的关系，并寻找 LRVE 的危险因素。采用队列研究设计，我们纳入了 3042 例接受改良腹股沟显微镜辅助精索静脉曲张切除术（MHMV）的精索静脉曲张患者。858 例（28.21%）LRVE 患者为研究组，2184 例（71.79%）无 LRVE 患者为对照组。与对照组相比，研究组的 BMI 较低（p<0.001）。术后共有 18 例患者复发，复发率为 0.59%。研究组中有 17 例（1.98%）患者和对照组中有 1 例（0.05%）患者复发，两组之间存在显著统计学差异（p<0.001）。LRVE 对精索静脉曲张复发的风险比为 43.27。总之，我们的 MHMV 复发率最低（0.59%）。LRVE 与精索静脉曲张复发有关，LRVE 的精索静脉曲张患者在精索静脉曲张手术后复发的可能性更高。BMI 可能是 LRVE 的危险因素。因此，对于精索静脉曲张患者，尤其是 BMI 较低的患者，应注意 LRVE。
