經(jīng)腹股溝入路與腹股溝外環(huán)下切口入路顯微精索靜脈結(jié)扎術(shù)治療青少年精索靜脈曲張的有效性和安全性比較

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Comparison of the efficacy and safety of inguinal and subinguinal approaches for microsurgical varicocelectomy in the treatment of adolescent varicocele

HUANG Yuanbiao KANG Huayin LI Zhigang GUO Chaoyong BAI Bing2

ABSTRACT：Objective To compare the degree，efficacy and safety of testicular catch-up growth after inguinal and subinguinal surgery for adolescent varicocele. Methods Clinical data of 121 adolescent varicocele patients with secondary testicular atrophy treated during Sep.2014 and Jun.2021 at Huili People＇s Hospital were retrospectively analyzed，including 40 cases treated with the inguinal incision approach，and 81 with the subinguinal approach. The characteristics of intraoperative， efficacy，surgical complications and prognosis were compared between the two groups. Results The inguinal group had significantly shorter microscope usage time （P=0.006），fewer number of preserved internal spermatic arteries （P＜0.001），and significantly larger diameter of preserved internal spermatic arteries than the subinguinal group （P=0.005）. The subinguinal group required ligation of more internal spermatic veins，and there were significantly more internal spermatic veins with a diameter of 4 mm or more （P＜0.001）. No recurrence occurred，and the incidences of scrotal edema and hydrocele were very low （P＞0.05）. Two years after surgery，the bilateral testicular volume of both groups was significantly larger than that before surgery （P＜0.05），and there was no significant difference in the testicles （P＞0.05）. Conclusion In the treatment of adolescent varicocele patients with secondary testicular atrophy，the subinguinal approach significantly reduces the difficulty of microsurgical varicocele ligation，and has good efficacy and safety，which is worthy of clinical promotion and application.

KEY WORDS：varicocele；adolescent；microsurgery；surgical approach；secondary atrophy of testicles；inguinal incision approach；subinguinal approach

摘要：目的 比較經(jīng)腹股溝與腹股溝外環(huán)下切口兩種手術(shù)入路的顯微精索靜脈結(jié)扎術(shù)治療合并睪丸繼發(fā)性萎縮的青少年精索靜脈曲張術(shù)后睪丸追趕性生長情況、療效及安全性。（剩余7734字）