[1]廖兵,曾德峰.. 腹腔镜下精索血管高位结扎术对精索静脉曲张患儿睾丸发育的影响研究[J].临床小儿外科杂志,2018,17(11):845-849.
　Liao Bing,Zeng Defeng.. Efficacy of laparoscopic highligation of spermatic cord on testicular development in children with varicocele.[J].Journal of Clinical Pediatric Surgery,2018,17(11):845-849.
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 腹腔镜下精索血管高位结扎术对精索静脉曲张患儿睾丸发育的影响研究

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年11期 页码: 845-849 栏目: 论著 出版日期: 2018-11-20
Title:
 Efficacy of laparoscopic highligation of spermatic cord on testicular development in children with varicocele.
作者:
 廖兵; 曾德峰.
 重庆三峡中心医院儿外一科
Author(s):
 Liao Bing; Zeng Defeng.
 Department of Pediatric Surgery,Chongqing Three Gorges Central Hospital,Chongqing 404000,China.
关键词:
 ; 腹腔镜;  精索血管高位结扎;  精索静脉曲张;  睾丸/生长和发育
Keywords:
 ; Laparoscopes;  High Ligation of Spermatic Vessels;  Varicocele; Testis/GD
文献标志码:
A
摘要:
 目的探讨腹腔镜下精索血管高位结扎术对精索静脉曲张患儿睾丸发育的影响。方法以2014年2月至2015年3月重庆三峡中心医院门诊及住院部收治的52例精索静脉曲张患儿为研究对象。采用腹腔镜下精索血管高位结扎术进行治疗，并随访至少1年，测量手术前后患侧曲张静脉最大直径和两侧睾丸体积，记录术后两侧睾丸血供、血运及术后并发症情况。结果52例患儿均成功完成手术，三孔法平均手术时间（40.32±11.06）min，单孔法平均手术时间（25.25±8.55）min。术后1 d患儿阴囊曲张静脉团明显缩小。术后无阴囊红肿、睾丸萎缩及鞘膜积液等并发症发生，随访期间无一例复发。经CDFI彩超检查，患儿睾丸血流状态和血运均良好，回声均匀。与术前比较，术后1、3、6个月时患儿患侧精索静脉曲张直径均显著减小（P<0.05）；与术前比较，术后3个月及术后6个月时患儿左侧睾丸体积均显著增大（P<0.05），且术后3个月患儿右侧睾丸体积显著大于左侧（P<0.05）。结论腹腔镜下精索血管高位结扎术治疗精索静脉曲张患儿安全可靠，睾丸发生萎缩的可能性小；经脐单孔腔镜手术操作简单，值得推广。
Abstract:
 ObjectiveTo explore the efficacy of laparoscopic highligation of spermatic cord on testicular development in children with varicocele.MethodsA total of 52 children with varicocele underwent laparoscopic highligation of spermatic cord and were followed up for 1 year.Summarize clinical data at pre and postoperation:maximal diameter of varicose veins,volume of testes;blood supply and blood flow of testis.Patient recovery and postoperative complications were recorded.ResultsAll operations were completed successfully.The average operative duration was (40.32±11.06) min by threehole laparoscopy and (25.25±8.55) min by transumbilical singleport laparoscopy.The varicose veins of scrotum decreased significantly at day 1 postoperation.No postoperative complications such as swelling of scrotum,atrophy of testis and hydrocele of tunica vaginalis occurred.There was no recurrence during followups.CDFI color Doppler ultrasound indicated that testicular blood flow was excellent and echoes were uniform.As compared with preoperative level,diameter of varicocele decreased significantly at 1-6 months (P<0.05) and left testicular volume expanded significantly at 3-6 months postoperation.From preoperative to 3 months postoperation,volume of right testis was significantly greater than that of left counterpart (P<0.05).ConclusionLaparoscopic highligation of spermatic cord is both safe and reliable for varicocele.And the possibility of testicular atrophy is low.Transumbilical singleport laparoscopy is simple so that it is worthy of clinical popularization.

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更新日期/Last Update: 2018-11-23