Comparison of Treatment Outcomes of Different Spermatic Vein Ligation Procedures in Varicocele Treatment
Comparison of Treatment Outcomes of Different Spermatic Vein Ligation Procedures in Varicocele Treatment
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不同精静脉结扎术治疗精索静脉曲张的疗效比较
DOI：
10.1097/mjt.0000000000000232
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发表时间：
2016-11-01
影响因子：
4.2
通讯作者：
Pu, Jin-Xian
中科院分区：
文献类型：
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作者：
Lv, Jin-Xing;Wang, Liang-Liang;Pu, Jin-Xian
在本研究中，根据复发率、术后并发症和精液质量，比较了4种不同精索静脉结扎治疗精索静脉曲张（VC）的方法。2012年1月至2013年5月，在苏州大学第一附属医院共招募了345例男性VC患者。采用不同结扎方式，将患者分为4组：腹腔镜下精索静脉曲张切除术组（LV组84例）、显微腹股沟精索静脉曲张切除术组（MIV组85例）、显微腹膜后精索静脉曲张切除术组（MRV组86例）、显微腹股沟下精索静脉曲张切除术组（MSV组90例）。MSV组手术时间55±6.9 min，明显长于LV、MIV、MRV组（P < 0.05）。LV组复发率为11.9%，高于MIV、MRV、MSV组（P < 0.05）。MSV组患者的阴囊水肿和睾丸萎缩明显减轻（P < 0.05），几乎所有患者的阴囊疼痛缓解率均显著高于LV、MIV和MRV组（P < 0.05）。MSV组精子浓度、a + b级精子数、精子活动力（%）均显著高于LV、MIV、MRV组（P < 0.05）。我们的研究表明，MSV是4种精索静脉结扎术中最有益的，可以作为不育男性VC的一线治疗方法。
In this study, 4 different spermatic vein ligation procedures for varicocele (VC) treatment were compared based on recurrence rate, postoperative complications, and semen quality. Between January 2012 and May 2013, a total of 345 male patients with VC were recruited at The First Affiliated Hospital of Soochow University. Patients were performed by different ligation procedures, and they were divided into 4 groups: laparoscopic varicocelectomy group (LV group: n = 84), microscopic inguinal varicocelectomy group (MIV group: n = 85), microscopic retroperitoneal varicocelectomy group (MRV group: n = 86), and microscopic subinguinal varicocelectomy group (MSV group: n = 90). In MSV group, the operative time was 55 ± 6.9 minutes, which was significantly longer than LV, MIV, and MRV groups (P < 0.05). Recurrence rate in LV group was at 11.9%, the highest rate observed compared with the MIV, MRV, and MSV groups (P < 0.05). Scrotal edema and testicular atrophy in MSV group were markedly decreased (P < 0.05), and scrotal pain was relieved in almost all patients in the MSV group at a significantly higher rate than LV, MIV, and MRV groups (P < 0.05). Sperm concentration, sperm count of grades a + b, and sperm motility (%) in the MSV group were sharply higher than LV, MIV, and MRV groups (all P < 0.05). Our study indicates that MSV is the most beneficial of the 4 spermatic vein ligation procedures and may be offered as the first-line treatment for VC in infertile men.