微型血管多普勒在改良腹股沟下显微精索静脉结扎术中的应用：附视频

目的 探讨微型血管多普勒在改良腹股沟下显微精索静脉结扎术中的应用价值.方法 回顾分析2012年1月至2013年1月期间中山大学附属第一医院东院收治的89例精索静脉曲张患者的临床资料.患者均行改良的腹股沟下显微精索静脉结扎术,2012年9月之前术中未应用微型血管多普勒,2012年9月之后术中常规应用微型血管多普勒辨别动脉和静脉.比较两组患者的临床资料.结果 89例患者共138次手术均获成功,术后随访3～6个月,未见睾丸萎缩和鞘膜积液发生.非多普勒组术中有1例精索内动脉被误扎,2例术中精索动静脉辨认不清,术后1例复发;多普勒组术中辨别动脉和静脉准确,无动脉损伤和误扎情况发生,术后无复发.结论 在微型血管多普勒辅助下行显微精索静脉结扎术更安全有效.

The application of microvascular doppler on modified subinguinal microsurgical varicocelectomy

Objective To evaluate the application of 20 MHz microvascular doppler on modified subinguinal microsurgical varicocelectomy.Methods From January 2012 to January 2013,89 patients with varicocele underwent modified subinguinal microsurgical varicocelectomy in East District of the First Affiliated Hospital.The microvascular doppler was not applied in the operative procedure for the discrimination of arteries and veins of the spermatic cord until September 2012.The outcomes of modified subinguinal microsurgical varicocelectomy with or without the assistance of microvascular doppler were compared.Results All patients were treated successfully and no postoperative complications such as testicular atrophy and/or hydeocele were found during 6 months postoperatively.For the group without microvascular doppler,accidental artery ligation occurred in one case and the internal spermatic vessels were unidentifiable in two cases.Recurrence occurred in one case.By contrast,the Microvascular Doppler was reliable for discerning arteries and veins.No artery injury or ligation occurred during the operation with microvascular doppler,and no recurrence occurred postoperatively.Conclusion Microvascular doppler assisted modified subinguinal microsurgical varicocelectomy could be safe and effective for treatment of varicocele.