腹腔镜2种术式治疗精索静脉曲张疗效观察

目的探讨腹腔镜2种术式治疗精索静脉曲张的疗效。方法140例精索静脉曲张患者随机分为2组各70例，A组采用腹腔镜精索血管高位集束结扎术（Palomo术式），B组采用腹腔镜单纯精索内静脉高位结扎术（Ivanissevich术式），比较2组术后精液质量改善情况，并发症发生率及复发率。结果2组术后精液质量均有明显改善（P％0．05），但组间比较差异无统计学意义（P〉O．05）；2组术后均未出现睾丸萎缩、鞘膜积液，阴囊水肿发生率比较差异无统计学意义（P〉0．05）；B组复发率高于A组（P〈0．05）。结论腹腔镜2种手术方式治疗精索静脉曲张均可获得满意疗效，Palomo术式复发率低，可作为腹腔镜治疗精索静脉曲张的首选术式。

Effect of two methods of laparoscopic varicocelectomy on spermatic varicocele

Objective To discuss the effect of two methods of laparoscopic varicocelectomy on spermatic varicocele. Methods A total of 140 cases of spermatic varicoeele were randomly divided into two groups, with 70 patients in each group. Group A underwent laparoscopic cluster ligation （Palomo technique） and group B underwent laparoscopic high ligation of spermatic vein （Ivanissevich technique）. The improvement of semen quality, the incidence rate of complications and recurrence rate were compared between two groups. Results The postoperative semen quality was improved significantly in both groups （P〈0. 05）, but there was no significant difference between groups （P〉0. 05）. No testicular atrophy, scrotal edema or hydrocele testis occurred in two groups. The recurrence rate was higher in group B than that in group A （P〈0, 05）. Conclusions Both of these two methods of laparoseopic varicoeelectomy are effective for spermatie varicocele. Palomo technique has the advantages of simple procedure and lower recurrence rate, and is the first choice for laparoscopic treatment of varicoeele.