CAJ | 학술논문

目的：通过膀胱镜在经腹膜后集束结扎精索血管术（palomo）中的运用，辨认睾丸动脉及淋巴管，减少睾丸萎缩和睾丸鞘膜积液的发生。方法选择原发性精索静脉曲张（VC）患者并进行手术治疗的患者75例，根据术式的不同分为膀胱镜下保留睾丸动脉、淋巴管的palomo术组（膀胱镜组）37例，单纯的palomo术组（palomo组）38例。比较两组术后睾丸萎缩、睾丸鞘膜积液和VC复发情况。结果术后6个月睾丸萎缩发生率膀胱镜组为0/37（0%），palomo组为3/38（7.89%），两组比较差异无统计学意义（P＞0.05）；术后睾丸鞘膜积液发生率膀胱镜组为2/37（5.41%），palomo组为10/38（26.3%），两组比较差异有统计学意义（P＜0.05）；术后复发的发生率分别为0/37（0%）、2/38（5.26%），两组比较差异无统计学意义（P＞0.05）。结论 palomo术中应用膀胱镜，术后睾丸鞘膜积液的发生率明显降低，VC复发率低,值得基层医院推广。
목적：통과방광경재경복막후집속결찰정색혈관술（palomo）중적운용，변인고환동맥급림파관，감소고환위축화고환초막적액적발생。방법선택원발성정색정맥곡장（VC）환자병진행수술치료적환자75례，근거술식적불동분위방광경하보류고환동맥、림파관적palomo술조（방광경조）37례，단순적palomo술조（palomo조）38례。비교량조술후고환위축、고환초막적액화VC복발정황。결과술후6개월고환위축발생솔방광경조위0/37（0%），palomo조위3/38（7.89%），량조비교차이무통계학의의（P＞0.05）；술후고환초막적액발생솔방광경조위2/37（5.41%），palomo조위10/38（26.3%），량조비교차이유통계학의의（P＜0.05）；술후복발적발생솔분별위0/37（0%）、2/38（5.26%），량조비교차이무통계학의의（P＞0.05）。결론 palomo술중응용방광경，술후고환초막적액적발생솔명현강저，VC복발솔저,치득기층의원추엄。
Objective To assess the clinical effects of cystoscope palomo varicoceletomy with a artery-lymphatics sparing in the treatment of primary varicocele. Methods A total of 75 patients with a mean age of 29.5 years who underwent varicocelectomy from 2009 to 2012 were divided into two groups: cystoscope group(37 cases received Cystoscope Palomo Varicoceletomy ), and Palomo group (38 cases received an Conventional Palomo Varicocelectomy). The incidences of recurrence, postoperative testicular hydrocele formation and the occurrence of orchiatrophy were comparatively analyzed between two groups. Results After 6 months follow-up, the incidence of testicular hydrocele was significantly lower in cystoscope group than that in Palomo group (2/37 [5.41%] versus 10/38 [26.3%]; P<0.05). There were no significant differences in rate of recurrence and orchiatrophy (0/37 [0%] versus 2/38 [5.26%], P>0.05; 0/37 [0%] versus 3/38 [7.89%], P >0.05). Conclusion Cystoscope Palomo Varicoceletomy is superior to Conventional Palomo Varicocelectomy in preserving the artery-lymphatics, lower incidence of postoperative testicular hydrocele formation and lower incidence of recurrence.