Minevich E, Wacksman J, Lewis A G, Sheldon C A
Division of Pediatric Urology, Children's Hospital Medical Center, University of Cincinnati, Ohio, USA.
J Urol. 1998 Mar;159(3):1022-4.
In large series of adults microsurgical varicocelectomy has been associated with extremely high success rates, combined with minimal incidence of postoperative hydrocele. We report our initial experience of inguinal varicocelectomy using an intraoperative microscope in adolescents.
From 1994 to 1996, 32 adolescents (mean age 15.3 years) underwent inguinal microsurgical varicocelectomy. An operative microscope and Doppler probe were used during spermatic cord dissection to identify and preserve the testicular artery and lymphatics.
All patients were available for followup, which ranged from 2 to 35 months (mean 20). There were no intraoperative complications. A temporary reactive hydrocele, which subsequently completely resolved, was observed in 1 patient. There were no palpable recurrent varicoceles.
The operative microscope permits reliable identification of the testicular artery and lymphatics, as well as venous channels in adolescents. As a result, the postoperative development of hydrocele or recurrence of the varicocele may be prevented.
在大量成人患者中，显微外科精索静脉曲张切除术成功率极高，术后鞘膜积液发生率极低。我们报告了在青少年中使用术中显微镜进行腹股沟精索静脉曲张切除术的初步经验。
1994年至1996年，32例青少年（平均年龄15.3岁）接受了腹股沟显微外科精索静脉曲张切除术。在精索解剖过程中使用手术显微镜和多普勒探头来识别和保留睾丸动脉及淋巴管。
所有患者均接受了随访，随访时间为2至35个月（平均20个月）。术中无并发症。1例患者出现了暂时性反应性鞘膜积液，随后完全消退。未触及复发性精索静脉曲张。
手术显微镜能够可靠地识别青少年的睾丸动脉、淋巴管以及静脉通道。因此，可以预防术后鞘膜积液的发生或精索静脉曲张的复发。
