腹腔镜下淋巴管保留在精索静脉高位结扎术中的应用

目的 探讨腹腔镜下保留淋巴管的精索静脉高位结扎术对术后并发症及对精液质量参数的影响.方法 自2009年5月至2013年7月,大朗医院对120例临床诊断明确为精索静脉曲张的患者随机分两组,A组60例行未保留淋巴管的精索静脉高位结扎术,B组60例行保留淋巴管的精索静脉高位结扎术.术后两组患者均随访12个月.结果 B组5例因术中染色不明显排除出组.术后睾丸鞘膜积液在A组出现8例（13.33％,8/60）,B组出现1例（1.81％,1/55）.阴囊疼痛在A组出现12例（20％）,B组出现3例（5.45％）.术后12个月精液异常在A组中31例（51.67％）得到明显改善,B组中有46例（83.64％）得到明显改善.两组差异均具有统计学意义.结论 腹腔镜下保留淋巴管的精索静脉曲张高位结扎术能够有效防止术后睾丸鞘膜积液、阴囊疼痛等并发症的发生,同时可以明显改善精液质量参数.

The clinical application of lymphatic-sparing laparoscopic varicocelectomy

Objecttive To investigate effects of lymphatic-sparing laparoscopic varicocelectomy on post-operative complications and seminal quality improvement.Methods From may 2009 to July 2013,120 varicocele patients in Dalang Hospital were randomly divided into two groups.60 cases in group A received lymphatic-ligation laparoscopic varicocelectomy,60 cases in group B received lymphatic-sparing laparoscopic varicocelectomy.All patients were followed up for 12 months.Results Five cases were excluded out of group B because of obscure staining.Hydrocele testis occurred in 8 cases of group A （13.33%,8/60） and 1 case of group B （1.81%,1/55） after the operation.12 cases in group A （20%,12/60） and 3 cases in group B （5.45%,3/60） complicated with scrotal pain.Semen parameters were improved dramatically in 31 cases of group A （51.67%,31/60） and 46 cases of group B（83.64%,46/60）,which had differences significantly between two groups.Conclusions Lymphatic-sparing laparoscopic varicocelectomy can reduce postoperative complications like hydrocele testis and scrotal pain,improve semen parameters.