经腹膜外途径腹腔镜下治疗双侧精索静脉曲张临床疗效分析

发布时间：2018-04-04 16:16

本文选题：精索静脉曲张　切入点：腹腔镜　出处：《中华男科学杂志》2017年11期

【摘要】：目的:观察经腹膜外途径腹腔镜下治疗双侧精索静脉曲张高位结扎的疗效。方法:回顾性分析48例经腹膜外途经腹腔镜下精索静脉高位结扎术及32例经腹腔途经腹腔镜下精索静脉高位结扎术患者。比较两组患者术前、术后l、3、6个月的精液质量变化情况,两组患者术中出血量、手术时间、术后胃肠功能恢复时间、术后并发症(皮下血肿、阴囊及皮下气肿、精索静脉曲张复发)以及配偶妊娠率等情况。结果:经腹膜外组和经腹腔组术后精液质量参数均较术前有明显改善(P0.05),但是术后1、3、6个月的精液质量参数比较无统计学差异(P0.05);两组术中出血量、手术时间[(38.27±9.23)min vs(43.46±11.72)min],无明显差异(P0.05),而胃肠道恢复时间经腹膜外途径组[(1.27±0.26)d]明显短于经腹腔途径组[(2.43±0.41)d,P0.05]。术后随访6~18个月,两组皮下血肿、阴囊及皮下气肿、复发率及配偶妊娠率无统计学差异(P0.05)。结论:经腹膜外途径腹腔镜下精索静脉高位结扎术具有恢复快、安全有效等优点,具有一定临床推广价值。
[Abstract]:Objective: to observe the effect of laparoscopic ligation of bilateral varicocele.Methods: 48 cases of high ligation of spermatic vein via laparoscope and 32 cases of high ligation of spermatic vein were analyzed retrospectively.The changes of semen quality were compared between the two groups before and after operation. Blood loss, operation time, postoperative gastrointestinal function recovery time, postoperative complications (subcutaneous hematoma, scrotal emphysema and subcutaneous emphysema) were compared between the two groups.Recurrent varicocele) and spouse pregnancy rate.Results: the semen quality parameters in the extraperitoneal group and the transperitoneal group were significantly improved compared with those before the operation, but there was no significant difference in the semen quality parameters between the two groups at 1 and 6 months after operation (P 0.05).The time of operation [38.27 卤9.23)min vs(43.46 卤11.72)min] had no significant difference (P 0.05), but the recovery time of gastrointestinal tract was significantly shorter in the extraperitoneal approach group [1.27 卤0.26 days] than that in the peritoneal approach group [2.43 卤0.41 days (P0.05)].Follow-up for 6 ~ 18 months showed that there was no significant difference in subcutaneous hematoma, scrotal and subcutaneous emphysema, recurrence rate and spouse pregnancy rate between the two groups (P 0.05).Conclusion: laparoscopic high ligation of spermatic vein via extraperitoneal approach has the advantages of quick recovery, safety and effectiveness, and has certain clinical value.
【作者单位】：南京鼓楼医院泌尿男科;
【基金】：国家自然科学基金(81571430)~~
【分类号】：R699.8

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