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目的:比较经皮小切口腹膜外超选择性精索静脉结扎和腹腔镜下精索静脉高位结扎术治疗精索静脉曲张的效果。方法:将884例精索静脉曲张患者分成两组,A组为经皮小切口腹膜外超选择性精索静脉结扎组,810例;B组为腹腔镜下精索静脉高位结扎组,74例;比较两组的手术时间、术后住院天数、住院费用、症状缓解率、并发症发生率和精液质量改善率等。结果:两组平均手术时间、术后住院天数相似,差异无统计学意义(P>0.05);A组住院费用比B组少,差异有统计学意义(P<0.05);A组复发率及睾丸鞘膜积液、阴囊水肿和附睾肿痛等术后并发症发生率低于B组,差异有统计学意义(P<0.05);两组术后6个月精液质量改善率相似,差异无统计学意义(P>0.05)。结论:经皮小切口腹膜外超选择性精索静脉结扎术属于微创手术,较腹腔镜下精索静脉高位结扎术具有复发率低、并发症少、住院费用低、疗效好和易推广等优点。
OBJECTIVE: To compare the effect of percutaneous transluminal ultra-selective varicocele ligation and laparoscopic varicocele ligation in the treatment of varicocele. Methods: A total of 884 patients with varicocele were divided into two groups: group A was percutaneous extra-small extraperitoneal extra-selective varicocelectomy (810 cases); group B was laparoscopic varicocele The operation time, postoperative hospital stay, hospitalization cost, symptom remission rate, complication rate and sperm quality improvement rate were compared between the two groups. Results: The average operation time and postoperative hospital stay were similar between the two groups (P> 0.05). The hospitalization cost in group A was less than that in group B, the difference was statistically significant (P <0.05). The recurrence rate in group A and The incidence of postoperative complications such as hydrocele, scrotum edema and epididymal edema were lower than those in group B (P <0.05). The improvement rate of semen quality was similar between the two groups at 6 months after operation Statistical significance (P> 0.05). Conclusion: Percutaneous small incision extraperitoneal ultra-selective varicocele ligation is minimally invasive surgery, compared with laparoscopic varicocele ligation has low recurrence rate, fewer complications, low hospitalization costs, good curative effect and easy to promote advantage.