Feasibility exploration of microscopic spermatic vein ligation for unilateral varicocele under daytime surgical mode_West China Medical Journal

Authors：

WANG Haitao , MU He , CUI Bo ,  SONG Dandan , XIN Wendi

1. Ambulatory Center of Anesthesiology Department, General Hospital of Northen Theater Command, Shenyang, Liaoning 110000, P. R. China;

Corresponding author：

SONG Dandan, Email: songdandan6@163.com

Keywords：

Daytime surgery; varicocele; microscope

DOI：

10.7507/1002-0179.202312224

Video：

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Objective To explore the feasibility of microscopic spermatic vein ligation for unilateral varicocele under daytime surgical mode. Methods The clinical data of patients with unilateral varicocele who underwent daytime surgical treatment at the General Hospital of Northen Theater Command between January and December 2022 were retrospectively analyzed. The relevant indicators of patients were collected, including age, surgical time, intraoperative blood loss, total hospitalization expenses, and postoperative condition. Results A total of 159 patients were included, aged 18-41 years, with an average age of (27.79±4.80) years, an average surgical time of (49.23±5.57) minutes, and an average intraoperative blood loss of (8.94±3.58) mL. One patient had fever, nausea and acid regurgitation on the 2nd day after discharge, and one patient had urinary retention on the day after operation. Five patients had a pain score of ≥3 in the surgical area on the 1st day after surgery. All patients had no postoperative incisions with bleeding or hematoma. Follow up showed that all patients returned to normal life on the 3rd day after surgery and returned to work on the 10th day after surgery. At 3-6 months after surgery, the sperm quality of 94 patients improved. One patient experienced disease recurrence 6 months after surgery. Conclusion Microscopic spermatic vein ligation for unilateral varicocele under daytime surgical mode is safe and feasible, and is worthy of promotion.

Citation： WANG Haitao, MU He, CUI Bo, SONG Dandan, XIN Wendi. Feasibility exploration of microscopic spermatic vein ligation for unilateral varicocele under daytime surgical mode. West China Medical Journal, 2024, 39(2): 200-203. doi: 10.7507/1002-0179.202312224 Copy

1.	Alsaikhan B, Alrabeeah K, Delouya G, et al. Epidemiology of varicocele. Asian J Androl, 2016, 18(2): 179-181.
2.	彭靖, 方冬, 张志超, 等. 精索静脉曲张或无精子症男性的睾酮水平. 北京大学学报(医学版), 2022, 54(2): 294-298.
3.	刘金炳, 陈智毅. 不育症患者精索静脉曲张程度超声分级与精液质量和性激素的相关性研究. 中国生育健康杂志, 2021, 32(5): 474-476.
4.	李志国, 苏刚岭, 刘石勇, 等. 不同手术方式治疗精索静脉曲张不育临床效果及与患者年龄的关系. 中国计划生育学杂志, 2022, 30(7): 1626-1630.
5.	黄健, 钟光俊. 精索静脉曲张的手术治疗进展. 国际泌尿系统杂志, 2021, 41(5): 936-938.
6.	Reesink DJ, Huisman PM, Wiltink J, et al. Sneeze and pop: a ruptured varicocele; analysis of literature, guided by a well-documented case-report. BMC Urol, 2019, 19(1): 14.
7.	Cho CL, Ho KL, Chan WK, et al. Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy - lessons learned from our initial experience. Int Braz J Urol, 2017, 43(5): 974-979.
8.	王艳, 吕晓辉, 田莽, 等. 腹腔镜与显微镜外环下精索静脉结扎术治疗官兵精索静脉曲张效果观察. 人民军医, 2021, 64(5): 429-432.
9.	Su JS, Farber NJ, Vij SC. Pathophysiology and treatment options of varicocele: an overview. Andrologia, 2021, 53(1): e13576.
10.	田汝辉, 陈慧兴, 赵亮宇, 等. 显微镜下精索静脉结扎术治疗非梗阻性无精子症伴精索静脉曲张的疗效与安全性. 中华医学杂志, 2018, 98(46): 3737-3740.
11.	赵小东, 刘琳, 马鹏程, 等. 显微镜下精索静脉结扎术治疗男性不育伴精索静脉曲张患者的疗效比较. 国际泌尿系统杂志, 2018, 38(5): 798-800.
12.	陈相军, 宋应寒, 陈敏, 等. 四川大学华西医院日间手术质量和安全管理规范. 华西医学, 2019, 34(2): 155-158.
13.	Bayot ML, Limaiem F. Biosafety guidelines. Treasure Island (FL): StatPearls, 2023.
14.	Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update, 2015, 21(4): 411-426.
15.	Keihani S, Verrilli LE, Zhang C, et al. Semen parameter thresholds and time-to-conception in subfertile couples: how high is high enough?. Hum Reprod, 2021, 36(8): 2121-2133.
16.	Lv MQ, Ge P, Zhang J, et al. Temporal trends in semen concentration and count among 327 373 Chinese healthy men from 1981 to 2019: a systematic review. Hum Reprod, 2021, 36(7): 1751-1775.
17.	Lima TFN, Frech FS, Patel P, et al, Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels. BJUI Compass, 2020, 1(3): 93-99.
18.	Birowo P, Tendi W, Widyahening IS, et al. The benefits of varicocele repair for achieving pregnancy in male infertility: a systematic review and meta-analysis. Heliyon, 2020, 6(11): e05439.
19.	Li X, Yang X, Wang X, et al. Comparison of outcomes in intrauterine insemination, in vitro fertilisation and intracytoplasmic sperm injection in men with and without varicocele. Int J Med Sci, 2020, 17(14): 2155-2162.
20.	Al-Mohammady AA, El-Sherbiny AF, Mehaney AB, et al. Varicocele repair in patients prepared for intracytoplasmic sperm injection: to do or not to do?. Andrologia, 2019, 51(2): e13185.
21.	范晓猛, 朱红伟, 朱志敏, 等. 不同手术方式治疗精索静脉曲张对睾丸功能的影响. 国际泌尿系统杂志, 2022, 42(3): 524-527.
22.	郭泽信, 韩大愚, 杨其运, 等. 加速康复外科理念在精索静脉曲张高位结扎手术中的应用. 广东医学, 2019, 40(17): 2478-2482.
23.	国际日间手术协会, 中国日间手术合作联盟. 日间手术发展与实践. 北京: 人民卫生出版社, 2016: 18, 49.
24.	白雪, 马洪升, 罗利. 中外日间手术发展对比研究及展望. 中国医院管理, 2014, 34(5): 35-37.
25.	何琼, 张静, 周维强, 等. 湖南省某院日间手术实施现状分析. 中国病案, 2017, 18(2): 56-59.
26.	刘云龙, 谷现恩, 张晓毅, 等. 精索静脉曲张所致阴囊疼痛经手术治疗缓解的影响因素 Meta 分析. 中华男科学杂志, 2017, 23(6): 550-560.
27.	王冠群, 周立新. 精索静脉显微结扎术治疗原发性精索静脉曲张的疗效观察. 中国性科学, 2019, 28(3): 51-54.
28.	杨永毅, 黄伟, 曹俊杰, 等. 结扎睾丸引带静脉对显微精索静脉曲张手术疗效的影响. 中华男科学杂志, 2018, 24(3): 226-230.

1. Alsaikhan B, Alrabeeah K, Delouya G, et al. Epidemiology of varicocele. Asian J Androl, 2016, 18(2): 179-181.
2. 彭靖, 方冬, 张志超, 等. 精索静脉曲张或无精子症男性的睾酮水平. 北京大学学报(医学版), 2022, 54(2): 294-298.
3. 刘金炳, 陈智毅. 不育症患者精索静脉曲张程度超声分级与精液质量和性激素的相关性研究. 中国生育健康杂志, 2021, 32(5): 474-476.
4. 李志国, 苏刚岭, 刘石勇, 等. 不同手术方式治疗精索静脉曲张不育临床效果及与患者年龄的关系. 中国计划生育学杂志, 2022, 30(7): 1626-1630.
5. 黄健, 钟光俊. 精索静脉曲张的手术治疗进展. 国际泌尿系统杂志, 2021, 41(5): 936-938.
6. Reesink DJ, Huisman PM, Wiltink J, et al. Sneeze and pop: a ruptured varicocele; analysis of literature, guided by a well-documented case-report. BMC Urol, 2019, 19(1): 14.
7. Cho CL, Ho KL, Chan WK, et al. Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy - lessons learned from our initial experience. Int Braz J Urol, 2017, 43(5): 974-979.
8. 王艳, 吕晓辉, 田莽, 等. 腹腔镜与显微镜外环下精索静脉结扎术治疗官兵精索静脉曲张效果观察. 人民军医, 2021, 64(5): 429-432.
9. Su JS, Farber NJ, Vij SC. Pathophysiology and treatment options of varicocele: an overview. Andrologia, 2021, 53(1): e13576.
10. 田汝辉, 陈慧兴, 赵亮宇, 等. 显微镜下精索静脉结扎术治疗非梗阻性无精子症伴精索静脉曲张的疗效与安全性. 中华医学杂志, 2018, 98(46): 3737-3740.
11. 赵小东, 刘琳, 马鹏程, 等. 显微镜下精索静脉结扎术治疗男性不育伴精索静脉曲张患者的疗效比较. 国际泌尿系统杂志, 2018, 38(5): 798-800.
12. 陈相军, 宋应寒, 陈敏, 等. 四川大学华西医院日间手术质量和安全管理规范. 华西医学, 2019, 34(2): 155-158.
13. Bayot ML, Limaiem F. Biosafety guidelines. Treasure Island (FL): StatPearls, 2023.
14. Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update, 2015, 21(4): 411-426.
15. Keihani S, Verrilli LE, Zhang C, et al. Semen parameter thresholds and time-to-conception in subfertile couples: how high is high enough?. Hum Reprod, 2021, 36(8): 2121-2133.
16. Lv MQ, Ge P, Zhang J, et al. Temporal trends in semen concentration and count among 327 373 Chinese healthy men from 1981 to 2019: a systematic review. Hum Reprod, 2021, 36(7): 1751-1775.
17. Lima TFN, Frech FS, Patel P, et al, Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels. BJUI Compass, 2020, 1(3): 93-99.
18. Birowo P, Tendi W, Widyahening IS, et al. The benefits of varicocele repair for achieving pregnancy in male infertility: a systematic review and meta-analysis. Heliyon, 2020, 6(11): e05439.
19. Li X, Yang X, Wang X, et al. Comparison of outcomes in intrauterine insemination, in vitro fertilisation and intracytoplasmic sperm injection in men with and without varicocele. Int J Med Sci, 2020, 17(14): 2155-2162.
20. Al-Mohammady AA, El-Sherbiny AF, Mehaney AB, et al. Varicocele repair in patients prepared for intracytoplasmic sperm injection: to do or not to do?. Andrologia, 2019, 51(2): e13185.
21. 范晓猛, 朱红伟, 朱志敏, 等. 不同手术方式治疗精索静脉曲张对睾丸功能的影响. 国际泌尿系统杂志, 2022, 42(3): 524-527.
22. 郭泽信, 韩大愚, 杨其运, 等. 加速康复外科理念在精索静脉曲张高位结扎手术中的应用. 广东医学, 2019, 40(17): 2478-2482.
23. 国际日间手术协会, 中国日间手术合作联盟. 日间手术发展与实践. 北京: 人民卫生出版社, 2016: 18, 49.
24. 白雪, 马洪升, 罗利. 中外日间手术发展对比研究及展望. 中国医院管理, 2014, 34(5): 35-37.
25. 何琼, 张静, 周维强, 等. 湖南省某院日间手术实施现状分析. 中国病案, 2017, 18(2): 56-59.
26. 刘云龙, 谷现恩, 张晓毅, 等. 精索静脉曲张所致阴囊疼痛经手术治疗缓解的影响因素 Meta 分析. 中华男科学杂志, 2017, 23(6): 550-560.
27. 王冠群, 周立新. 精索静脉显微结扎术治疗原发性精索静脉曲张的疗效观察. 中国性科学, 2019, 28(3): 51-54.
28. 杨永毅, 黄伟, 曹俊杰, 等. 结扎睾丸引带静脉对显微精索静脉曲张手术疗效的影响. 中华男科学杂志, 2018, 24(3): 226-230.

West China Medical Journal

Feasibility exploration of microscopic spermatic vein ligation for unilateral varicocele under daytime surgical mode

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