Clinical efficacy of high-selective laparoscopic high ligation of spermatic vein
10.3760/cma.j.cn115396-20190604-00087
- VernacularTitle:腹腔镜下高选择性精索静脉高位结扎术临床疗效分析
- Author:
Jiansen CHEN
1
Author Information
1. 南阳市第二人民医院泌尿外科 473000
- From:
International Journal of Surgery
2020;47(9):624-627
- CountryChina
- Language:Chinese
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Abstract:
Objective:To evaluate the clinical efficacy and safety of high-selective laparoscopic high ligation of spermatic vein for the treatment of varicocele.Methods:A retrospective analysis was performed about 419 cases clinical data which have received high-selective laparoscopic high ligation of spermatic vein in Nanyang Second General Hospital from January 2010 to December 2018. The patients were divided into endoscopy group ( n=289) and open group ( n=130). the patients of endoscopy group were treated with laparoscopic high ligation of spermatic vein, the patients of open group were treated with high ligation of spermatic vein according inguinal incision. The operation time, hospital stay, intraoperative blood loss, postoperative analgesic application, postoperative complications, recurrence, and postoperative semen quality improvement were compared between the two groups. Measurement data were presented as mean±standard deviation ( Mean± SD), and comparison between groups was performed by t-test; count data groups using Chi-square test. Results:This group of 419 patients were all successful operation, all patients with intraoperative and postoperative stable vital signs. The operation time [(26.78±5.14) min vs (61.45±9.75) min], hospitalization time [(4.14±0.39) d vs (10.62±1.19) d] of the patients in the endoscopy group was better than that of the open group, and the difference were statistically significant ( P<0.01). Comparison of intraoperative blood loss between the two groups [(18.32±3.05) mL to (29.14±2.41) mL], the difference was not statistically significant ( P=0.053). The postoperative analgesic application rate, complication rate, and recurrence rate of patients in the endoscopic group were 12.5% (36/289), 2.1% (6/289), and 0.7% (2/289), respectively. The control group was 13.8%(18/130), 7.7% (10/130), 5.4% (7/130), the difference between the two groups were statistically significant ( P<0.05). The postoperative semen quality of the two groups of patients improved to varying degrees. There were 357 cases with definite improvement in postoperative semen quality, including 231 cases in the endoscopic group and 126 cases in the open group, but the difference between the two groups was not statistically significant ( P>0.05). Conclusions:High-selective laparoscopic high ligation of the spermatic vein for the treatment of varicocele, the operation is quick, the high ligation of the varicocele does not damage the blood supply of the testicular artery, the complication rate is low, and the recurrence rate is low. It is worthy of clinical application.
