门诊局麻下微型腹腔镜精索内静脉高位结扎术.docVIP

临床泌尿外科杂志JOURNAL OF CLINICAL UROLOGY 门诊局麻下微型腹腔镜精索内静脉高位结扎术(附127例报告) 陈泽波　彭毅　蔡志明　黄东平　叶秀桃　李太富　张俊刚 　　摘要　目的：改变泌尿外科患者需入院→开刀→抗感染→拆线→出院等传统治疗模式，改变常规腹腔镜手术需全麻、费用高、体内残留金属异物的状况。方法：采用局麻，在门诊应用直径4 mm微型腹腔镜及丝线作精索内静脉高位结扎治疗精索静脉曲张127例。结果：127例全部完成手术，术时未见明显出血及脏器损伤，无一例中转手术。术后随访106例，精索静脉曲张复发率为7.5%。结论：本术式是一种医患均乐意接受的新术式，可作为当天外科的一个项目。　　关键词　微型腹腔镜　精索静脉曲张　局部麻醉　精索内静脉高位结扎术 Mini-laparoscopic ligation of spermatic veins in outpatients with varicocele under local anesthesia (Report of 127 cases) CHEN Ze-bo　PEN Yi　CAI Zhi-ming　HUANG Dong-ping　YE Xiu-tao（Department of Urology,Luohu Region Hospital, Shenzhen City, Guangdong, 518001）LI Tai-fu　ZHANG Jun-gang（Department of Anesthesia,Luohu Region Hospital,Shenzhen City, Guangdong） 　　Abstract　Purpose: An increasing number of operative procedures in urology can be performed by laparoscopy. We report our experience with mini-laparoscopic spermatic veins ligation by silk suture, which is a typical operative in outpatients of varicocele and a simple technique for suture ligation. Methods: Mini-laparoscopic spermatic vein ligation by silk suture was performed in 127 outpatients (12 to 37 years olds,28 bilateral and 99 unilateral) since Nov.1993. With the patient under local anesthesia the pneumoperitoneum was induecd , three-4 mm-trocars were inserted, the spermatic veins were ligtured by silk suture and the retroperitoneum was sutured by silk suture. Results: All operations were completed as planned under local anesthesia. Blood loss was more minimal and there were no intraoperative or postoperative complications. Mean postoperative hospital stay is 2 hours. Conclusions: Mini laparoscopic spermatic vein ligation is feasible and minimally invasive. This procedure can be performed in outpatients and it′s an effective and simple treatment for varicocele. It′s a technique of Day Surgery.　　Key words　Mini-laparoscopy　Varicocele　Local anesthesia　High ligation of internal spermatic cord vein 　　自我们1992年12月成功地开展了电视腹腔镜精索内静脉高位钛夹夹闭术以来，为了改变患者需住院、全麻、费用高等状况，我们在腹腔镜操作