The Analysis Of The Effects Of Two Different Laproscopic Surgical Procedure To Varicocelectomy

Objective : To analyse the therapy effects of two different laproscopic surgical approaches to varicoceletomy(laparoscopic high selective ligation of spermatic veins group and laparoscopic cluster ligation group)by comparing operation time,early and long-term complications,recurrence,semen quality.Methods:The study covered 135 patients with the diagnosis of varicocele from May 2014 to August 2015 in the department of urology of the General Hospital of Beijing Military Area Command,which were single diseases and had no history of the relative surgery.The patients were divided in two groups :group A(laparoscopic cluster ligation group)and group B(laparoscopic high selective ligation of spermatic veins).There are 58 cases in group A and 77 cases in group B.Then compare the operation time,early and long-term complications,recurrence,semen quality and testicular volume,and to evaluate the therapy effects of the two different laproscopic surgical methods.Results : All patients had an successful operation,and the symptoms had been improved obviously.The operation time of the group B(the unilateral:24.29±2.01 min,the bilateral:32.72±3.13 min)is longer than the group A(the unilateral:14.59±2.03 min,the bilateral:23.62±2.52min)(P<0.05).The postoperative sperm density of group A is better than the preoperative sperm density(26.62±5.26*10~6/ml VS 21.55±3.11*10~6/ml,P<0.05),the a+b% has the same result(36.45±5.93% VS 30.36±6.88%,P<0.05).And the postoperative sperm density of group B is better than the preoperative sperm density(26.29±3.99*10~6/ml VS 22.48±3.08*10~6/ml,P<0.05),the a+b% of group B is improved,too(36.27±4.81% VS 28.34±7.14%,P<0.05).The 51(66.2%)of 77 cases of group B had improvement of semen quality and 27(46.6%)of 58 cases of group A,Thelaparoscopic high selective ligation of spermatic veins group had a better result than the laparoscopic cluster ligation group(P<0.05).The 11(19.0%)0f 58 cases of group A occurred hydrocele testis and 2(2.6%)of 77 cases of group B;the laparoscopic high selective ligation of spermatic veins group set lower incidence of postoperative hydrocele testis(P<0.05).The 3(5.2%)of 58 cases of group A occurred testicular atrophy and none of 77 cases of group B;the laparoscopic high selective ligation of spermatic veins group set lower incidence of postoperative testicular atrophy(P<0.05).The7(12.1%)of 58 cases of group A occurred postoperative recurrence and 1(1.3%)of 77 cases of group B;the laparoscopic high selective ligation of spermatic veins group set lower incidence of postoperative recurrence(P<0.05).Conclusion : Although the operation time of the laparoscopic high selective ligation of spermatic veins group is longer than laparoscopic cluster ligation group,but set lower incidence of hydrocele testis ? testicular atrophy and recurrence,and the improvement of semen quality is better,too.So it should be the choice of urological surgeons.