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目的:评估输尿管镜下双孔腹腔镜精索静脉高位结扎术的应用价值。方法:回顾性分析2008年6月至2009年6月11例精索静脉曲张患者采用输尿管镜下双孔腹腔镜精索静脉高位结扎术的治疗效果及安全性,随访3～15个月。结果:11例患者术前精子计数为(1 463±128)×104/ml,11例手术均获成功,手术时间为16～28 min,平均(19.4±1.1)min,术中无出血,无肠管及血管损伤。术后无需用镇痛药,术后第1日下床活动,第3日出院,疗效满意。术后3个月精子计数为(2 609±208)×104/ml,与术前相比有明显提高,差异有统计学意义(P<0.01);随访中未见精索静脉曲张复发,无睾丸萎缩发生。结论:输尿管镜下双孔腹腔镜精索静脉高位结扎术疗效确切、并发症少、恢复较快且具有简便易行、微创美观等优点。
Objective: To evaluate the value of dual-port laparoscopic varicocele ligation under ureteroscopy. Methods: The clinical data and safety of 11 patients with varicocele undergoing ureteroscopic double-hole laparoscopic varicocele ligation from June 2008 to June 2009 were retrospectively analyzed. The follow-up was 3 to 15 months. Results: The preoperative sperm counts in 11 patients were (1463 ± 128) × 104 / ml. All the 11 cases were successful. The operation time was 16-28 min (mean, 19.4 ± 1.1) min, no bleeding during operation, Intestinal and vascular injury. After surgery without analgesics, get out of bed after the first day of activity, discharged on the 3rd, the effect is satisfactory. The sperm count at 3 months postoperatively was (2 609 ± 208) × 104 / ml, which was significantly higher than that before operation (P <0.01). No recurrence of varicocele was found during follow-up. Testicular atrophy occurs. Conclusions: The ureteroscopic double-hole laparoscopic varicocele ligation has definite effect, less complications, faster recovery, simple and easy operation, minimally invasive appearance and so on.