Study On Percutaneous Internal Jugular Vein Puncture And Embolization For The Treatment Of Left Primary Varicocele

Objective:In this study,a comparative study was conducted to explore the efficacy and advantages of interventional embolization via internal jugular vein for Varicocele.Objects and methods:In this study,patients with left side Varicocele were treated in the Department of Vascular Surgery and Urology of the First People's Hospital of Chenzhou Hospital from September 2017 to September 2019.The patients met the inclusion criteria.The patients were randomly divided into three groups:the open surgery group(group A),the femoral vein puncture access group(group B),and the transjugular vein puncture access group(group C).They were treated with open surgery(Palomo),Interventional embolization therapy via femoral vein puncture approach and interventional embolization therapy via internal jugular vein puncture approach respectively.the related indexes of perioperative period,preoperative and postoperative 3 months between group C and group A and B were compared,and statistical analysis was performed.Results:Surgery was successfully completed in all three groups.Semen examination preoperative and 3 months after operation in group C:the semen volume was(2.31±0.78)ml and(3.25 ± 0.84)ml,respectively.The semen concentrations were(9.24±4.18)×10,/ml and(30.69±8.24)×106/ml,respectively.Total sperm(22.59±14.41)×106/ml and(82.92±40.01)×106/ml,respectively.The proportion of forward motile sperm(17.27±8.79)%and(39.11±13.75)%,respectively.The number of motile sperm forward(34.58±26.05)×106/ml and(4.17±3.75)×106/ml respectively.The number of active sperm(5.98±5.02)×106/ml and(39.58±28.57)×106/ml,respectively.The difference of the above indexes of semen examination preoperative and 3 months after operation in group C have statistical significance(P<0.05).Postoperative,in Groups A and C:The semen volume was(3.09 ± 0.62)ml and(3.25±0.84)ml,respectively.The proportion of forward motile sperm was(37.49±13.25)%and(39.11±13.75)%,respectively.The number of forward moving sperm was(41.24 ± 23.32)×106/ml and(4.17±3.75)?106/ml,respectively,and the number of active sperm was(47.38 ± 25.49)×106/ml and(39.58 ± 28.57)×106/ml,respectively.Thedifference in postoperative improvement between the two groups has no statistical significance(all P>0.05).In group C and group B,The operation time was(41.23±11.05)min and(18.24±5.11)min,respectively.The time from Postoperative to getting out of bed was(11.27 ± 0.87)h and(3.35±0.49)h,respectively.The hospitalization time was(27.27±1.41)h and(11.93±2.00)h,respectively,The hospitalization cost was(9973.67±838.38)yuan and(7622.83±1563.57)yuan,respectively.The dosage of contrast agent was(52.83±7.51)ml and(32.16±4)ml respectively.The radiation doses were(666.11±159.23)mGy and(204.34±78.17)mGy,respectively.The satisfaction degree of the approach was(3.70±0.92)and(4.67±0.48),the overall comfort degree after operation was(92.87±3.54)and(105.40±2.84),respectively.The overall satisfaction degree of hospitalization was(110.67±10.19)and(120.57±11.01),respectively.The differences in the above indicators of group B and group C were statistically significant(all P<0.05).The total incidence of complications in group A,B and C were 30.0%(9/30),20.0%(6/30),and 23.3%(7/30),respectively.There was no significant difference between the groups,(P>0.05).Conclusion:1.the semen quality of patients(semen quantity,semen concentration,total number of sperm,proportion of forward moving sperm,number of forward moving sperm,number of moving sperm,etc.)can be significantly improved by interventional operation;The effect of interventional operation and open operation on improving semen quality is equivalent.2.Transjugular approach interventional embolization for Varicocele has shortens the operation time,reduces the amount of surgical radiation,reduces the hospitalization cost,shortens the length of hospitalization,reduces the amount of contrast agent,advances the time of getting out of bed after surgery,improves the satisfaction with the approach,and has high overall hospitalization satisfaction.The advantages of good postoperative overall comfort are worthy of promotion.