腹腔镜精索静脉高位结扎术治疗精索静脉曲张26例报告

目的：探讨腹腔镜精索静脉高位结扎治疗精索静脉曲张的临床价值，总结保留睾丸动脉的单纯精索内静脉高位结扎术及睾丸动静脉集柬高位结扎术的优缺点。方法：回顾分析腹腔镜精索静脉高位结扎术治疗精索静脉曲张26例患者的临床资料，其中14例行保留睾丸动脉的单纯精索内静脉高位结扎术，12例行睾丸动静脉集柬高位结扎术。结果：26例手术均获成功。6例术前诊断为左侧精索静脉曲张的病例术中确诊为双侧精索静脉曲张。睾丸动静脉集柬高位结扎术中1例并发附睾炎。以不育就诊的14例中，保留睾丸动脉的单纯精索内静脉结扎的8例中4例生育，而睾丸动静脉集柬高位结扎的6例中只有1例生育，全部病例未见复发。结论：腹腔镜下精索内静脉高位结扎术具有损伤小，视野清楚，操作简单，并发症少，术后恢复快等优点，尤其适合双侧精索静脉曲张者，可同时探查和治疗双侧精索静脉曲张。保留睾丸动脉的单纯精索内静脉高位结扎术能提高不育症的疗效，减少鞘膜积液的发生率。

High ligation of varicocele under laparoscopy

Objective:To explore the value of laparoscopic varicocelectomy and to make a comparison between cluster ligation of internal spermatic veins and arteries and ligation of testicular veins alone.Methods:Over a 22-month period,26 patients underwent laparoscopic treatment of varicocele,in which 14 underwent ligation of the veins alone,and 12 underwent ligation of testicular veins and arteries.Results:One patient who underwent cluster ligation had a left epididymitis.There were 4 patients recovered the fertility after the operations of ligation of the veins alone,with a comparision,only 1 in the group of ligation of testioular veins and arteries.There were no recurrence of varicocele in our series.Conclusions:This preliminay experience shows that the results of the laparoscopic approach are as well as those of the open approach.The ligation of the testicular veins alone is preferable to the ligation of testicular veins and arterise.The laparoscopic approach is a safe and simple surgical technique.