Efficacy of abdominal wall stapler assisted single-port laparoscopy in the treatment of varicocele
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摘要: 目的 分析在腹壁吻合器辅助下通过单孔单通道腹腔镜治疗精索静脉曲张的效果。方法 选取2021年6月—2023年2月徐州医科大学附属连云港医院通过腹壁吻合器辅助单孔单通道腹腔镜与传统三孔腹腔镜治疗精索静脉曲张的80例患者，采用随机区组设计将80例患者分为试验组和对照组，试验组给予腹壁吻合器辅助单孔单通道腹腔镜手术治疗，对照组给予常规传统腹腔镜手术治疗，比较2组患者的手术时间、术中出血量、术后住院时间、术后Kiyak问卷评分、手术费用、视觉模拟量表(VAS)评分及术后6个月的精液相关检查。结果 2组患者经过不同的手术方式后，术后Kiyak问卷评分、VAS评分、术中出血量比较差异均有统计学意义(P < 0.05)，而手术时间、术后住院时间、手术治疗费用及精液相关检查比较差异均无统计学意义(P>0.05)。结论 相比传统腹腔镜手术治疗精索静脉曲张，腹壁吻合器辅助下的单孔单通道腹腔镜降低了手术难度，且更加安全、可行，且被广大患者接受。Abstract: Objective To analyze the effect of single-port laparoscopic varicocele treatment assisted by abdominal wall stapler.Methods The clinical data of 80 patients with varicocele treated by abdominal wall stapler assisted single-port laparoscopic surgery and traditional three-port laparoscopic surgery in Lianyungang Hospital Affiliated to Xuzhou Medical University from June 2021 to February 2023 were collected. The 80 patients were divided into group A and group B. Group A was treated by abdominal wall stapler assisted single-port single-channel laparoscopic surgery. The operation time, intraoperative blood loss, postoperative hospital stay, postoperative Kiyak questionnaire score, operation cost, visual analogue scale(VAS) and semen related examination were compared between the two groups.Results There were significant differences in postoperative Kiyak questionnaire score, visual analogue scale(VAS), and intraoperative blood loss between the two groups after different surgical methods(P < 0.05). There were no significant differences in operation time, postoperative hospital stay, surgical treatment cost or semen related examinations between the two groups(P>0.05).Conclusion Compared with traditional laparoscopic surgery in the treatment of varicocele, single-port laparoscopic surgery assisted by abdominal wall stapler reduces the difficulty of operation, and is safer, more feasible and acceptable.
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表 1 2组精索静脉曲张患者的临床指标比较
X±S 指标 试验组(40例) 对照组(40例) t P值 术后住院天数/d 2.13±0.65 2.25±0.71 -0.82 0.412 总费用/元 14 491.93±1 885.54 13 653.91±1 903.40 0.35 0.051 手术时间/min 40.48±4.66 38.75±6.34 1.39 0.170 术中出血量/mL 4.85±1.55 6.20±1.36 -2.60 0.005 VAS评分/分 4.05±0.68 6.73±0.75 46.95 < 0.001 Kiyak问卷评分/分 4.72±0.45 4.00±2.23 7.87 < 0.001 
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表 2 术后6个月精液相关检测
X±S 组别 精子数目/(×106/次) 精子前向运动率/% 正常形态精子率/% 试验组 41.6±2.1 33.2±4.1 4.4±0.5 对照组 40.8±2.4 32.9±4.0 4.3±0.4 t 1.638 0.263 1.409 P值 0.106 0.794 0.163
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