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目的:探讨在采用精索静脉高位结扎术治疗原发性精索静脉曲张的手术方法中,腹腔镜和腹股沟小切口改良Palo-mo手术各自应用价值和特点。方法:回顾性分析44例应用腹腔镜和45例腹股沟小切口改良Palomo精索静脉高位结扎术的病例。比较两组在手术时间,术后运用镇痛剂比例,平均住院时间,治疗费用,并发症发生率。B超随访1年检测复发率,术侧睾丸情况。结果:腹腔镜和腹股沟小切口腹腔镜组在治疗精索静脉曲张疗效无统计学意义,前者费用高于小切口手术组(P<0.05),有2例术后发生睾丸萎缩(4.55%),其他指标差异无统计学意义(P>0.05)。结论:精索静脉高位结扎术治疗原发性精索静脉曲张的手术方法中,腹腔镜和小切口改良Palomo手术比较未必具备明显优势。单侧精索静脉曲张,小切口改良Palomo精索静脉高位结扎术仍值得首先推荐,有腹腔手术粘连病例尤其如此。对于双侧和复发的精索静脉曲张,则可考虑腹腔镜手术。
OBJECTIVE: To explore the value and characteristics of modified Laparoscopic and small groin modified Palo-mo surgery in the surgical treatment of primary varicocele with varicocele ligation. Methods: A retrospective analysis of 44 patients with laparoscopic and 45 cases of groin incision improved Palomo spermatic vein ligation of the cases. The two groups were compared in the operation time, postoperative analgesic ratio, the average length of stay, treatment costs, complication rates. B-year follow-up detection of recurrence rate, the side of the testis. Results: Laparoscopic and groin incision laparoscopic group had no significant difference in the treatment of varicocele, the cost of the former was higher than that of the small incision group (P <0.05), and the incidence of testicular atrophy (4.55%) was found in 2 cases. Other indicators showed no significant difference (P> 0.05). CONCLUSIONS: Laparoscopic and small-incision modified Palomo surgery may not have obvious advantages compared with varicocele ligation in the surgical treatment of primary varicocele. Unilateral varicocele, small incision improved Palomo varicocele ligation is still the first recommendation, especially in cases of abdominal adhesions. For bilateral and recurrent varicocele, you can consider laparoscopic surgery.