Ulusoy Oktay, Karakus Osman Zeki, Ateş Oğuz, Hakgüder Faika Gülce, Olguner Mustafa, Akgür Feza Miraç
Department of Pediatric Surgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Department of Pediatric Surgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
J Pediatr Surg. 2020 Aug;55(8):1610-1612. doi: 10.1016/j.jpedsurg.2019.07.008. Epub 2019 Jul 19.
In this study, we aimed to compare the effects of testicular vein ligation level on complications encountered; i.e. high-level ligation cranial to the linea terminalis vs ligation caudal to the linea terminalis.
A total of 47 unilateral adolescent patients, treated with laparoscopic varicocelectomy between January 2004 and December 2017, were reviewed retrospectively. Patients were divided into two groups in terms of ligation level: caudal to the linea terminalis as group 1 and cranial to the linea terminalis as group 2. Symptoms, varicocele grades, preoperative testicular growth arrest, operative method, hydrocele formation, postoperative recurrence and testicular catch-up growth were recorded.
The mean operation time was 38.6 ± 10.2 min (34-53 min) in group 1 and was 33.6 ± 6.4 min (29-42 min) in group 2. Single hydrocele occurred in the laparoscopic nonselective varicocelectomy in group 1 (4.5%) and was successfully treated with open hydrocelectomy. Single varicocele recurrence was observed in the laparoscopic selective varicocelectomy in group 1 (4.5%) and treated with laparoscopic nonselective varicocelectomy cranial to the linea terminalis.
The high-level ligation of the spermatic veins cranial to the linea terminalis during laparoscopic varicocelectomy, independent of the technique applied, may contribute to reasonable low hydrocele and recurrence rates.
Level III.
在本研究中，我们旨在比较睾丸静脉结扎水平对所遇到并发症的影响；即耻骨线以上高位结扎与耻骨线以下结扎。
回顾性分析2004年1月至2017年12月期间接受腹腔镜精索静脉结扎术治疗的47例单侧青少年患者。根据结扎水平将患者分为两组：耻骨线以下为第1组，耻骨线以上为第2组。记录症状、精索静脉曲张分级、术前睾丸生长停滞、手术方法、鞘膜积液形成、术后复发及睾丸追赶生长情况。
第1组平均手术时间为38.6±10.2分钟（34 - 53分钟），第2组为33.6±6.4分钟（29 - 42分钟）。第1组腹腔镜非选择性精索静脉结扎术中出现1例单纯鞘膜积液（4.5%），经开放鞘膜积液切除术成功治疗。第1组腹腔镜选择性精索静脉结扎术中观察到1例精索静脉曲张复发（4.5%），经耻骨线以上腹腔镜非选择性精索静脉结扎术治疗。
腹腔镜精索静脉结扎术中耻骨线以上精索静脉高位结扎，无论采用何种技术，可能有助于使鞘膜积液和复发率合理降低。
三级。
