经脐单孔腹腔镜下精索内静脉高位结扎术46例临床分析.docVIP

经脐单孔腹腔镜下精索内静脉高位结扎术46例临床分析 李彦锋，孙中义，吴 刚，梁培和，张 勇，周 波，王洛夫，靳风烁 (400042 重庆，第三军医大学大坪医院野战外科研究所泌尿外科) [摘要] 目的 寻求治疗精索静脉曲张的微创新技术并对经脐单孔腹腔镜下精索内静脉高位结扎术的临床经验进行总结。方法 回顾分析我院2009年1月至2010年6月采用经脐单孔双通道法（双Trocar法），进行腹腔镜下精索内静脉高位结扎术治疗的46例精索静脉曲张患者的临床资料。结果 46例患者均为Ⅱ～Ⅲ度精索静脉曲张, 年龄15～29岁，平均21.5岁；病史6个月至8年，平均2.5年；左侧42例，双侧4例；所有手术均采用精索血管集束结扎方式顺利完成，手术时间15～40 min，平均21 min；出血量0～5ml；住院时间2～5 d，平均3.5 d；随访2～18个月，无静脉曲张复发，阴囊水肿，无睾丸萎缩等远期并发症。结论 经脐单孔腹腔镜下精索内静脉高位结扎术安全快捷，创伤小，并发症少，恢复快,腹壁不留疤痕，是治疗精索静脉曲张的微创新术式，宜于推广使用。 [关键词] 精索静脉曲张;单孔腹腔镜;精索内静脉结扎术 [中图法分类号] [文献标志码] A A novel modified trans-umbilical laparoendoscopic single-site varicocelectomy: a report of 46 cases Li Yanfeng, Sun Zhongyi, Wu Gang, Liang Peihe, Zhang Yong, Zhou Bo, Wang Luofu, Jin Fengshuo ( Department of urology，Daping Hospital，Institute of Surgery Research， Third Military Medical University，Chongqing 400042, China) [Abstract] Objective To summarize our experience with a novel modified trans-umbilical laparoendoscopic single-site technique of varicocelectomy for the treatment of varicocele and analyze the clinical value of this method. Methods　 A novel modified trans-umbilical laparoendoscopic single-site technique without any access platform with several channels for instrumentation was created and employed for the varicocelectomy. The clinical data of patients that underwent varicocelectomy by this modified technique were analyzed retrospectively. Results　Forty six patients with varicocele (age, 21.5 (15-29) years; course of disease, 2.5 (0.5-8) years) underwent varicocelectomy by this modified method. Among them, 42 patients had varicocele on the left side, and 4 on both sides. The mean operation duration was 21(15-40) minutes. The mean blood loss was less than 5 ml and the mean hospital stay was 3.5 (2-5) days. All the operations were successful and no recurrences and complications were found during the follow-up period for 2 to 18 months. Conclusion　The novel modified laparoendoscopic single-site varico