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目的:初步探讨单孔腹腔镜精索静脉高位结扎术的可行性、安全性和优越性。方法:2010年7～12月应用单孔3通道技术,经腹腔途径进行双侧精索静脉高位结扎术5例。患者平均年龄31.6岁;平均体重指数24.0 kg/m~2;术中应用标准腹腔镜器械、Triport 3孔通道和5 mm头端可弯腹腔镜。记录患者手术时间、估计术中出血量、术中并发症、术后疼痛指数(VAPS)、术后住院时间等临床资料,并对结果进行分析。结果:5例均顺利完成手术,无中转为标准腹腔镜或者开放手术。平均手术时间60.1 min;中位术中出血量5 ml;无术中并发症;中位VAPS为1分;术后切口均愈合良好,外观几乎无可见瘢痕;平均术后住院时间2天。结论:单孔腹腔镜精索静脉高位结扎术有良好的临床可行性和安全性,几乎无可见瘢痕。但其临床效果尚需进一步大样本临床对照研究予以证实。
Objective: To investigate the feasibility, safety and superiority of single port laparoscopic high varicocele ligation. Methods: From July to December 2010, 5 patients were treated with single-hole 3-channel technique and bilateral high varicocele ligation was performed by intraperitoneal route. The mean age of patients was 31.6 years. The mean body mass index was 24.0 kg / m ~ 2. The standard laparoscopic instruments, Triport 3-hole channel and 5 mm head-end flexible laparoscopy were used. The patient’s operation time, estimated intraoperative blood loss, intraoperative complications, postoperative pain index (VAPS), postoperative hospital stay and other clinical data were recorded, and the results were analyzed. Results: All the 5 cases completed the operation smoothly without any standard laparoscopic or open surgery. The average operation time was 60.1 minutes. The median blood loss was 5 ml. There was no intraoperative complications. The median VAPS score was 1. All incisions healed well and the appearance of scar was almost normal. The average postoperative hospital stay was 2 days. Conclusion: Single hole laparoscopic varicocele ligation has good clinical feasibility and safety, almost no visible scar. However, the clinical results still need further large-scale clinical controlled studies to be confirmed.