Abstract：
OBJECTIVE: To evaluate the clinical efficacy of microscopic internal spermatic-inferior epigastric vein anastomosis in the treatment of left varicocele and compare it with microscopic spermatic vein ligation for the same condition.
METHODS: A retrospective analysis of 74 patients with left varicocele between July 2020 and July 2022 was performed. The patients were divided into two groups based on the surgical method used. Group A consisted of 37 patients who underwent microscopic internal spermatic-inferior epigastric vein anastomosis, while Group B consisted of 37 patients who underwent microscopic spermatic vein ligation. Comparison of preoperative and postoperative semen quality, reproductive hormone levels, scrotal ultrasound results, duration of surgery, length of hospital stay, postoperative recurrence rate, and occurrence of complications with a follow-up time of 12 mo between two groups.
RESULTS: Both groups showed significant improvements in semen quality and serum reproductive hormone levels. The Group A demonstrated significantly improved sperm forward motility compared to Group B, but had longer operation times and hospital stays (P < 0.05). After 1 year of follow-up, 8 partners in Group A and 6 partners in Group B achieved natural conception, with no significant difference between the two groups. There were no recurrences observed in either group during the follow-up period, and no significant statistical differences were found in other postoperative observation indicators.
CONCLUSIONS: Both microscopic internal spermatic-inferior epigastric vein anastomosis and microscopic spermatic vein ligation are effective surgical methods for treating left varicocele. Anastomosis surgery provides greater improvement in sperm motility, although it is associated with longer operation times and hospital stays.
METHODS: A retrospective analysis of 74 patients with left varicocele between July 2020 and July 2022 was performed. The patients were divided into two groups based on the surgical method used. Group A consisted of 37 patients who underwent microscopic internal spermatic-inferior epigastric vein anastomosis, while Group B consisted of 37 patients who underwent microscopic spermatic vein ligation. Comparison of preoperative and postoperative semen quality, reproductive hormone levels, scrotal ultrasound results, duration of surgery, length of hospital stay, postoperative recurrence rate, and occurrence of complications with a follow-up time of 12 mo between two groups.
RESULTS: Both groups showed significant improvements in semen quality and serum reproductive hormone levels. The Group A demonstrated significantly improved sperm forward motility compared to Group B, but had longer operation times and hospital stays (P < 0.05). After 1 year of follow-up, 8 partners in Group A and 6 partners in Group B achieved natural conception, with no significant difference between the two groups. There were no recurrences observed in either group during the follow-up period, and no significant statistical differences were found in other postoperative observation indicators.
CONCLUSIONS: Both microscopic internal spermatic-inferior epigastric vein anastomosis and microscopic spermatic vein ligation are effective surgical methods for treating left varicocele. Anastomosis surgery provides greater improvement in sperm motility, although it is associated with longer operation times and hospital stays.
摘要：
目的：评价显微精索内-腹壁下静脉吻合术治疗左精索静脉曲张的临床疗效，并与相同情况下显微精索静脉结扎术进行比较。
方法：对2020年7月至2022年7月的74例左精索静脉曲张患者进行回顾性分析。根据所使用的手术方法将患者分为两组。A组37例患者行显微精索内-腹壁下静脉吻合术,而B组包括37例接受显微镜下精索静脉结扎术的患者。术前、术后精液质量比较,生殖激素水平,阴囊超声检查结果,手术持续时间,住院时间,术后复发率,两组患者随访12个月,并发症发生情况。
结果：两组精液质量和血清生殖激素水平均有显著改善。与B组相比，A组表现出显着改善的精子前向运动性，但手术时间和住院时间较长(P<0.05)。随访1年后,A组8名合伙人和B组6名合伙人实现了自然概念，两组间无显著性差异。在随访期间，两组均未观察到复发，术后其他观察指标差异无统计学意义。
结论：显微精索内-腹壁下静脉吻合术和显微精索静脉结扎术均是治疗左精索静脉曲张的有效手术方法。吻合手术提供了更大的改善精子运动，尽管它与更长的手术时间和住院时间有关。
方法：对2020年7月至2022年7月的74例左精索静脉曲张患者进行回顾性分析。根据所使用的手术方法将患者分为两组。A组37例患者行显微精索内-腹壁下静脉吻合术,而B组包括37例接受显微镜下精索静脉结扎术的患者。术前、术后精液质量比较,生殖激素水平,阴囊超声检查结果,手术持续时间,住院时间,术后复发率,两组患者随访12个月,并发症发生情况。
结果：两组精液质量和血清生殖激素水平均有显著改善。与B组相比，A组表现出显着改善的精子前向运动性，但手术时间和住院时间较长(P<0.05)。随访1年后,A组8名合伙人和B组6名合伙人实现了自然概念，两组间无显著性差异。在随访期间，两组均未观察到复发，术后其他观察指标差异无统计学意义。
结论：显微精索内-腹壁下静脉吻合术和显微精索静脉结扎术均是治疗左精索静脉曲张的有效手术方法。吻合手术提供了更大的改善精子运动，尽管它与更长的手术时间和住院时间有关。
