显微精索静脉结扎术治疗复发性精索静脉曲张（附37例报告）

周明宽; 张亚东; 吕坤龙; 庄锦涛; 赵亮; 余敬威; 邓春华; 涂响安

doi:10.13201/j.issn.1001-1420.2018.08.007

显微精索静脉结扎术治疗复发性精索静脉曲张（附37例报告）

- 中山大学附属第一医院男科(广州, 510080)
基金项目:
国家自然科学基金(编号81172432、81471449、81671449)

广东省科技计划项目(编号2016B030230001、2013B051000021、2016A020214004、2016A020218007)

广州市科技计划项目(编号2013J4500010、201604020189)

详细信息

通讯作者: 涂响安,E-mail:txabs9988@163.com

中图分类号: R697

收稿日期: 2018-07-02

Microsurgical varicocelectomy in the treatment of recurrent varicocele（Report of 37cases）

- Department of Andrology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China

More Information

Corresponding author: TU Xiang'an, E-mail: txabs9988@163.com

Received Date: 02 July 2018

摘要

摘要: 目的:探讨复发性精索静脉曲张(VC)经腹股沟下显微精索静脉结扎术治疗的疗效。方法:回顾性分析2012年1月~2016年12月我院收治的37例复发性VC患者的临床资料及术后3、6、12个月的回访资料,分析术后疗效。结果:复发性VC患者平均手术时间为82.6min,手术结扎左侧精索内静脉条数平均12.8条,术后疼痛缓解率为89.7%。不育患者配偶自然妊娠率为40.0%。所有患者随访均无睾丸萎缩和鞘膜积液发生。结论:腹股沟下显微精索静脉结扎术治疗复发性VC安全、有效,长期效果仍需进一步大样本、多中心前瞻性研究。
- 复发性 /
- 精索静脉曲张 /
- 显微手术 /
- 结扎术
Abstract: Objective:To investigate the curative effects of recurrent varicocele treated by subinguinal microsurgical varicocelectomy.Method:From January 2012 to December 2016, there were 37 patients with recurrent varicocele who received subinguinal microsurgical varicocelectomy.The number of spermatic veins and curative effects were recorded.The effects of surgeries were observed through follow-up visits at 3, 6 and 12 months after the operation.Result:The average time of patients with recurrent varicocele was 82.6 min, and the mean number of internal spermatic veins ligated on the left side was 12.8.The rate of postoperative pain remission was 89.7%, and the spontaneous pregnancy rate was 40.0%.No patients experienced postoperative complications as testicular atrophy or hydrocele.Conclusion:Subinguinal microsurgical varicocelectomy is a safe and effective treatment for recurrent vacicocele, but further large sample and multicenter prospective studies are still needed to confirm the long-term effects.
- recurrent /
- varicocele /
- microsurgery /
- ligation

HTML全文

参考文献(18)

[1]	梁朝朝, 王克孝, 陈家应, 等.合肥地区5 172名男性青少年外生殖器疾病的流行病学调查[J].中华医学杂志, 1997, 77 (1):16-18.
[2]	Akbay E, Cayan S, Doruk E, et al.The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents[J].BJU Int, 2000, 86 (4):490-493.
[3]	Abdel-Meguid T A, Al-Sayyad A, Tayib A, et al.Does varicocele repair improve male infertility?An evidencebased perspective from a randomized, controlled trial[J].Eur Urol, 2011, 59 (3):455-461.
[4]	Zini A, Fischer A, Bellack D, et al.Technical modification of microsurgical varicocelectomy can reduce operating time[J].Urology, 2006, 67 (4):803-806.
[5]	涂响安, 赵良运, 赵亮, 等.精素静脉曲张性慢性睾丸痛的显微外科治疗[J].中华显微外科杂志, 2013, 36 (4):409-410.
[6]	Cayan S, Shavakhabov S, Kadioglu A.Treatment of palpable varicocele in infertile men:a meta-analysis to define the best technique[J].J Androl, 2009, 30 (1):33-40.
[7]	Rotker K, Sigman M.Recurrent varicocele[J].Asian J Androl, 2016, 18 (2):229-233.
[8]	管日戬, 李森, 王进, 等.左肾静脉受压与精索静脉曲张术后复发关系的探讨[J].临床泌尿外科杂志, 2017, 32 (2):122-126.
[9]	Hopps C V, Lemer M L, Schlegel P N, et al.Intraoperative varicocele anatomy:a microscopic study of the inguinal versus subinguinal approach[J].J Urol, 2003, 170 (6Pt 1):2366-2370.
[10]	Lv K L, Zhuang J T, Zhao L, et al.Varicocele anatomy during subinguinal microsurgical varicocelectomy in Chinese men[J].Andrologia, 2015, 47 (10):1190-1195.
[11]	Libman J L, Segal R, Baazeem A, et al.Microanatomy of the left and right spermatic cords at subinguinal microsurgical varicocelectomy:comparative study of primary and redo repairs[J].Urology, 2010, 75 (6):1324-1327.
[12]	吕坤龙, 邬健斌, 吴观土, 等.腹股沟下显微精索静脉结扎术与腹膜后精索内静脉高位结扎术疗效比较[J].新医学, 2015, 46 (3):153-156.
[13]	Leung L, Ho K L, Tam P C, et al.Subinguinal microsurgical varicocelectomy for male factor subfertility:tenyear experience[J].Hong Kong Med J, 2013, 19 (4):334-340.
[14]	Cho K S, Seo J T.Effect of varicocelectomy on male infertility[J].Korean J Urol, 2014, 55 (11):703-709.
[15]	Wang J, Xia S J, Liu Z H, et al.Inguinal and subinguinal micro-varicocelectomy, the optimal surgical management of varicocele:a meta-analysis[J].Asian J Androl, 2015, 17 (1):74-80.
[16]	Grober E D, Chan P T, Zini A, et al.Microsurgical treatment of persistent or recurrent varicocele[J].Fertil Steril, 2004, 82 (3):718-722.
[17]	Chawla A, Kulkarni G, Kamal K, et al.Microsurgical varicocelectomy for recurrent or persistent varicoceles associated with orchalgia[J].Urology, 2005, 66 (5):1072-1074.
[18]	Cayan S, Akbay E.Fate of Recurrent or Persistent Varicocele in the Era of Assisted Reproduction Technology:Microsurgical Subinguinal Redo Varicocelectomy Versus Observation[J].Urology, 2018, 117:64-69.