摘要
目的探讨3D高清腹腔镜保留睾丸动脉的精索静脉高位结扎术的临床疗效与应用价值。方法回顾性分析2018年至2021年就诊于中国医科大学附属盛京医院的82例精索静脉曲张患者临床资料,其中行3D高清腹腔镜保留睾丸动脉的精索静脉高位结扎术(A组)27例,行3D高清腹腔镜精索血管集束高位结扎术(B组)24例,显微镜精索静脉结扎术(C组)31例。比较三组患者在术中出血量、手术时间、住院时间上的差异,同时对比手术前后患者精子活力、浓度、数量,比较术后复发以及并发症(附睾炎、鞘膜积液、睾丸萎缩)的发生情况。结果C组的手术出血显著少于其余两组(P<0.05),A、B两组的手术时间均显著短于C组(P<0.05),三组在住院时间上差异无统计学意义(P>0.05)。三组患者精子活力、精子浓度、精子数量均较术前明显提高(P<0.05),A组精子活力显著高于其余两组(P<0.05)。在术后复发和相关并发症的发生情况的对比中,A组与其他两组的差异均无统计学意义(P>0.05)。结论3D高清腹腔镜保留睾丸动脉的精索静脉高位结扎术临床疗效佳,值得广泛应用。
Objective To evaluate the clinical efficacy and value of 3D laparoscopic testicle artery sparing varicocelectomy.Methods The clinical data from varicocele patients in Shengjing Hospital of China Medical University from 2018 to 2021 were analyzed retrospectively.27 cases admitted in Group A who were operated by 3D laparoscopic testicle artery sparing varicocelectomy,24 cases admitted in Group B who operated by 3D laparoscopic varicocelectomy without sparing testicle artery.31 cases admitted in Group C who operated by microscopic varicocelectomy.Operational blood loss and time,hospital stay,sperm vitality,sperm concentration,sperm count,recurrence,relevant postoperative complications(epididymitis,hydrocele,testicular atrophy)were observed and compared among three groups.Results Intraoperative blood loss in Group C was significantly less than the other two groups(P<0.05).The operative duration of Group A and B were both shorter than Group C(P<0.05).No significant difference was found in hospital stay among three groups(P>0.05).The sperm vitality,sperm concentration and sperm count of all groups were improved compared to the preoperative(P<0.05).Sperm vitality of Group A was significantly higher than the other two groups(P<0.05).There was no significant difference in the recurrence and complications between Group A and the other two groups(P>0.05).Conclusions 3D laparoscopic testicle artery sparing varicocelectomy shown excellent clinical efficiency and worth widely used in the clinic.
作者
叶鉴锋
王润邦
张墨
Ye Jianfeng;Wang Runbang;Zhang Mo(Department of Urology,Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of Urology,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2023年第3期265-269,共5页
Chinese Journal of Endourology(Electronic Edition)
基金
国家自然科学基金面上项目(82173372,81802540)
白求恩泌尿肿瘤专项研究基金青年项目(mnz1202023)。
