摘要
目的探讨腹腔镜下高选择性精索静脉高位结扎术在精索静脉曲张患者中的安全性和临床疗效。方法回顾性分析2010年1月—2018年12月于南阳市第二人民医院接受高选择性腹腔镜下精索静脉高位结扎术的419例患者的病例资料,根据手术方式不同将其分为腔镜组(n=289)和开放组(n=130)。腔镜组患者采用腹腔镜下精索静脉高位结扎术,开放组患者采用经腹股沟切口行精索静脉高位结扎术。比较两组患者的手术时间、住院时间、术中出血量、术后镇痛药应用情况、术后并发症情况、复发情况和术后精液质量改善情况。计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用χ^2检验。结果本组419例患者全部手术成功,全部患者术中、术后生命体征平稳。腔镜组患者的手术时间[(26.78±5.14)min比(61.45±9.75)min]、住院时间[(4.14±0.39)d比(10.62±1.19)d]优于开放组,差异具有统计学意义(P<0.01)。两组患者的术中出血量比较[(18.32±3.05)mL比(29.14±2.41)mL],差异无统计学意义(P=0.053)。腔镜组患者的术后镇痛药应用率、并发症发生率、复发率分别为12.5%(36/289)、2.1%(6/289)、0.7%(2/289),对照组分别为13.8%(18/130)、7.7%(10/130)、5.4%(7/130),两组比较差异均具有统计学意义(P<0.05)。两组患者的术后精液质量均有不同程度改善,术后精液质量明确好转者357例,其中腔镜组231例,开放组126例,但两组比较差异无统计学意义(P>0.05)。结论高选择性腹腔镜下精索静脉高位结扎术治疗精索静脉曲张,手术操作快捷,高位结扎曲张静脉,不损伤睾丸动脉血供,并发症发生率低,复发率低,值得在临床推广应用。
Objective To evaluate the clinical efficacy and safety of high-selective laparoscopic high ligation of spermatic vein for the treatment of varicocele.Methods A retrospective analysis was performed about 419 cases clinical data which have received high-selective laparoscopic high ligation of spermatic vein in Nanyang Second General Hospital from January 2010 to December 2018.The patients were divided into endoscopy group(n=289)and open group(n=130).the patients of endoscopy group were treated with laparoscopic high ligation of spermatic vein,the patients of open group were treated with high ligation of spermatic vein according inguinal incision.The operation time,hospital stay,intraoperative blood loss,postoperative analgesic application,postoperative complications,recurrence,and postoperative semen quality improvement were compared between the two groups.Measurement data were presented as mean±standard deviation(Mean±SD),and comparison between groups was performed by t-test;count data groups using Chi-square test.Results This group of 419 patients were all successful operation,all patients with intraoperative and postoperative stable vital signs.The operation time[(26.78±5.14)min vs(61.45±9.75)min],hospitalization time[(4.14±0.39)d vs(10.62±1.19)d]of the patients in the endoscopy group was better than that of the open group,and the difference were statistically significant(P<0.01).Comparison of intraoperative blood loss between the two groups[(18.32±3.05)mL to(29.14±2.41)mL],the difference was not statistically significant(P=0.053).The postoperative analgesic application rate,complication rate,and recurrence rate of patients in the endoscopic group were 12.5%(36/289),2.1%(6/289),and 0.7%(2/289),respectively.The control group was 13.8%(18/130),7.7%(10/130),5.4%(7/130),the difference between the two groups were statistically significant(P<0.05).The postoperative semen quality of the two groups of patients improved to varying degrees.There were 357 cases with definite improvement in postoperative semen quali
作者
陈建森
Chen Jiansen(Department of Urology,Nanyang Second General Hospital,Nanyang 473000,China)
出处
《国际外科学杂志》
2020年第9期624-627,共4页
International Journal of Surgery
