经腹股沟和经腹股沟下途径显微镜精索静脉结扎术的疗效对比

目的比较经腹股沟和经腹股沟下途径显微镜精索静脉结扎术治疗精索静脉曲张的安全性和疗效。方法回顾性分析我院2016年1月至2019年6月显微镜精索静脉结扎术治疗精索静脉曲张145例资料,经腹股沟途径53例,经腹股沟下途径92例。比较两组手术时间、结扎精索静脉数量、阴囊疼痛缓解率、精子质量改善情况及并发症(睾丸鞘膜积液、睾丸萎缩、复发)。结果经腹股沟途径手术比经腹股沟下途径手术时间短(34.2±5.0)min vs(37.8±8.4)min,t=–3.245,P=0.001],且结扎精索内静脉数量少(6.1±1.3)根vs(8.3±1.5)根,t=–9.171,P<0.001]。两组术后精子质量改善情况、阴囊疼痛缓解率及并发症发生率差异无统计学意义。结论显微镜下经腹股沟和经腹股沟下途径精索静脉结扎术治疗精索静脉曲张均疗效确切而且安全。经腹股沟途径需结扎的精索内静脉少,手术时间短。

Comparison of efficacy between inguinal and subinguinal microscopic varicocelectomy

Objective To compare the efficacy and safety between microscopic inguinal and subinguinal varicocelectomy for varicocele.Methods The data of 145 cases underwent microscopic varicocelectomy in our hospital from January 2016 to June 2019 were analyzed retrospectively.Microscopic inguinal varicocelectomy(MIV)and microscopic subinguinal varicocelectomy(MSV)were performed in 53 and 92 patients.Operation duration,number of ligated veins,postoperation scrotum pain relief rate,and changes of sperm parameters were compared between the two groups.Complications,such as hydrocele,testicular atrophy,and recurrence of varicocele,were compared between the two groups.Results Operation duration was significantly shorter in the MIV group than in the MSV group(34.2±5.0)min vs(37.8±8.4)min,t=–3.245,P=0.001].And the number of ligated veins was significantly fewer in the MIV group(6.1±1.3)veins vs(8.3±1.5)veins,t=–9.171,P<0.001].No statistically significant difference was found between the two groups in terms of changes of sperm parameters,postoperation scrotum pain relief rate,and complications.Conclusion Microscopic inguinal and subinguinal varicocelectomy are both safe and effective in treatment of varicocele.Subinguinal approach need fewer veins ligated and shorter operation duration.