Objective To investigate the recent effect of different surgical methods in the treatment of adolescent patients with primary varicocele. Methods Two hundred and seventy-four adolescent patients with primary varicocele were divided into three groups according to the operative methods: one hundred and seventy-eight cases of open high level ligation of varicocele via retroperitoneum (open surgery group) .seventy-nine cases of iaparoscope varicocelectomy (laparoscope group), seventeen cases of microsurgery varicocelectomy ( microsurgery group) ;the recent effects of three groups were compared and analyzed. Results All the operations in three groups were completed successfully. There was no significant difference in the postoperative stay in hospital among three groups(P>0.05).There were significant differences in operation time,hospital cost among three groups(P < 0. 01) ,the operation time was shortest,and the hospital cost was least in open surgery group. The bleeding in operation in open surgery group was significant less than that in laparoscope and microsurgery group (P <0.01 ) , but there was no significant difference between laparoscope group and microsurgery group( P > 0.05). The postoperative restoration time of gastrointestinal function in open surgery group and microsurgery group was significantly shorter than that in laparoscope group( P < 0. 01), but there was no significant difference between open surgery group and microsurgery group (P > 0.05). The open surgery group had four cases of postoperative recurrence,one case of incisional infection,two cases of urinary retention ;laparoacopic group had one case of epididymitis, one case of postoperative bleeding and two cases of urinary retention ; microsurgical group had neither postoperative recurrence nor recent complications. Conclusion Open high level ligation of varicocele via retroperitoneum has the characteristics with simple operation, short operative time, few bleeding in operation and low treatment cost;laparoscopic varicocelectomy applies to patients with bilateral varicocele or aesthetic requirements; microsurgical varicocelectomy takes the advantages with the significant improvement in symptoms and few complication.%目的 探讨青少年原发性精索静脉曲张不同手术方式的近期治疗效果.方法 274例青少年原发性精索静脉曲张患者根据手术方式分为3组:开放手术腹膜后精索静脉高位结扎组(开放手术组)178例,腹腔镜精索静脉高位结扎组(腹腔镜组)79例和显微镜下精索静脉结扎组(显微镜组)17例；对比分析3组患者的近期疗效.结果 3组患者手术均顺利完成.3组患者术后住院时间比较差异无统计学意义(P＞0.05).3组手术时间、住院费用比较差异均有统计学意义(P＜0.01),开放手术组手术时间最短,住院费用最低.开放手术组术中出血量显著少于腹腔镜组和显微镜组(P＜0.01),但腹腔镜组与显微镜组比较差异无统计学意义(P＞0.05).开放手术组、显微镜组术后胃肠功能恢复时间显著短于腹腔镜组(P＜0.01),但开放手术组与显微镜组比较差异无统计学意义(P＞0.05).开放手术组术后复发4例,切口感染1例,尿潴留2例；腹腔镜组出现附睾炎1例,出血1例,尿潴留2例；显微镜组无术后复发及近期并发症.结论 开放手术腹膜后精索静脉高位结扎术具有操作简单、手术时间短、术中出血量少及治疗费用低等特点；腹腔镜精索静脉高位结扎术较适合于双侧精索静脉曲张或具有美观要求者；显微镜下精索静脉结扎术具有症状改善明显、并发症少等优势.
展开▼
