经脐单孔无气腹腹腔镜下治疗精索静脉曲张性不育的效果观察

目的了解经脐单孔法无气腹腹腔镜精索静脉高位结扎术治疗精索静脉曲张性不育的临床疗效。方法选取精索静脉曲张患者40例,行经脐单孔法无气腹腹腔镜精索静脉高位结扎术,观察患者的手术时间、术后住院天数、术后并发症及术后3个月时精液质量改善情况。结果 40例患者术后均顺利完成,无明显出血影响手术操作,无严重手术并发症,术后阴囊坠胀不适感均消失或减轻,阴囊触诊扩张迂曲的静脉明显缩小,Valsava试验阴性。其中单侧患者手术时间为18~25 min,平均24.2 min;双侧患者手术时间为35~47 min,平均36.7 min。平均住院时间2.4 d。经过3个月随访,无复发病例,术后3个月复查精液常规,精液质量明显改善,术后精子密度、活率、（A＋B）级精子比例与术前比较差异有统计学意义（P〈0.05）。结论经脐单孔腹腔镜精索静脉高位结扎术可作为治疗精索静脉曲张性不育的一种可选术式,可取得良好的临床疗效。

Observation on Therapeutic Effect of Varicocele Infertility by Transumbilical Single-port Gasless Laparoscopy

Objective To investigate the clinical effectiveness of Treatment of varicocele infertility by transumbilical single port gasless laparoscopy. Methods Eighty cases underwent transumbilical single port gasless laparoscopic high ligation of spermatic vein(61 cases on the left side,19 cases on both sides). Results All of the operations were successfully.No complication was observed and no case had recurrence.The average operative time was 24.2 min on the 1eft side and 36.7 min on both sides.Mean postoperative hospital stay was 2.4 d.After three months follow-up examination of semen,there were significantly differences between sperm count,motility rate,and A+B sperm scale before surgery and three months after surgery. Conclusions Transumbilical single port gasless laparoscopic high ligation of spermatic vein is a feasible alternative to cure varicocele infertility,it can achieve satisfactory clinical effectiveness.