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目的:对比经脐单孔单通道与单孔双通道腹腔镜手术治疗青少年精索静脉曲张的疗效。方法:将80例精索静脉曲张患儿随机分成两组(单通道组及双通道组各40例)。对比两组的手术时间、术后住院时间、切口疼痛评分、术后并发症、腹壁美容满意度评分。结果:两组手术均获成功。虽然双通道组术后切口疼痛视觉模拟评分(VAS)高[(3.6±1.1)分vs(4.8±1.4)分,t=-4.986,P<0.01],但两组的手术时间[(31.2±4.6)min vs(29.8±4.2)min,t=1.383,P=0.171]、术后住院时间[(1.82±0.8)d vs(1.95±0.7)d,t=-0.784,P=0.436]、术后并发症(0 vs 0)和腹壁美容满意度[(4.8±0.5)分vs(4.6±0.6)分,t=1.253,P=0.214]均无明显差异。术后6个月两组均无复发,无脐疝、鞘膜积液及睾丸萎缩等并发症,腹壁无可见手术瘢痕。结论:在严格掌握手术适应证的前提下,经脐单孔单通道与单孔双通道腹腔镜治疗精索静脉曲张疗效相当,腹壁不留瘢痕,双通道腹腔镜手术无需特殊器械,更值得临床推广。
OBJECTIVE: To compare the efficacy of transumbilical single hole and single hole dual laparoscopic transurethral one-hole transesophageal varices for adolescent varicocele. Methods: Eighty children with varicocele were randomly divided into two groups (40 in single-channel group and two-channel group). The operation time, postoperative hospital stay, incision pain score, postoperative complications and abdominal cosmetic satisfaction score were compared. Results: Both procedures were successful. Although the visual analogue scale (VAS) was significantly higher in the two-channel group ([3.6 ± 1.1] vs 4.8 ± 1.4, t = -4.986, P <0.01) 4.6) min vs 29.8 ± 4.2 min, t = 1.383, P = 0.171], postoperative hospital stay (1.82 ± 0.8 d vs (1.95 ± 0.7) d, t = -0.784, P = 0.436) Postoperative complications (0 vs 0) and abdominal cosmetic satisfaction [(4.8 ± 0.5) vs (4.6 ± 0.6) points, t = 1.253, P = 0.214] were not significantly different. There was no recurrence after 6 months in the two groups, no complications such as umbilical hernia, hydrocele and testicular atrophy, no visible surgical scar in the abdominal wall. Conclusion: Under strict control of surgical indications, single-hole and single-hole laparoscopic transvaginal umbilical single-hole laparoscopic treatment of varicocele is equivalent to the abdominal wall without scarring, double-laparoscopic surgery without special equipment, more worthy of clinical Promotion.