硬膜外麻醉下腹腔镜手术治疗双侧精索静脉曲张临床研究

目的探讨硬膜外麻醉下腹腔镜双侧精索内静脉高位结扎术的疗效和安全性。方法采用硬膜外麻醉，行腹腔镜双侧精索内静脉高位结扎术42例，与开放手术进行疗效比较。结果全部手术顺利成功，术后随访1年以上无睾丸萎缩发生。腹腔镜组平均手术时间（21．24±6．85）min，术后平均住院时间（2．10±0．85）d，与开放手术组比较，手术时间和住院时间差异有统计学意义（P〈0．05）；腹腔镜组平均住院费用（4858±435）元，开放手术组平均住院费用（4849±415）元，2组住院费用差异无统计学意义（P〉0．05）。术后随访1年，2组精子密度、精子活力、（A＋B）级精子比率和精子畸形率差异均无统计学意义（均P〉0．05）。结论硬膜外麻醉下行腹腔镜双侧精索内静脉高位结扎术简便可行，创伤小，手术效果好。

Clinical analysis of laparoscopic ligation of spermatic veins in treatment of varicocele under combined spinal and epidural anesthesia

Objective The aim of this study is to assess the safety and effectiveness of laparoscopic ligation of spermatic veins for treatment of varicocele. Methods Forty-two patients were treated by laparoscopic varieocelectomy under combined spinal and epidural anesthesia (CSEA). All patients preoperatively underwent ultrasound scan of the testicles (color Doppler). The control group was treated with open surgical therapy. Results All patients were followed up for over 1 year. No testieular atrophy occurred. Mean operation time of laparoscopicgroup and control group was (21.24±6.85) min and (38.24±7.86) min (P<0.05) respectively. Compared with control group, the count, vigour, and activity of sperm showed no difference in laparoscopie group after operation. Conclusion The laparoscopic ligation of spermatic veins for treatment of varicocele is safe and effective.