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, 張志超, 等. 精索靜脈曲張或無精子癥男性的睪酮水平. 北京大學學報(醫學版), 2022, 54(2): 294-298.
3.	劉金炳, 陳智毅. 不育癥患者精索靜脈曲張程度超聲分級與精液質量和性激素的相關性研究. 中國生育健康雜志, 2021, 32(5): 474-476.
4.	李志國, 蘇剛嶺, 劉石勇, 等. 不同手術方式治療精索靜脈曲張不育臨床效果及與患者年齡的關系. 中國計劃生育學雜志, 2022, 30(7): 1626-1630.
5.	黃健, 鐘光俊. 精索靜脈曲張的手術治療進展. 國際泌尿系統雜志, 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.	王艷, 呂曉輝, 田莽, 等. 腹腔鏡與顯微鏡外環下精索靜脈結扎術治療官兵精索靜脈曲張效果觀察. 人民軍醫, 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.	田汝輝, 陳慧興, 趙亮宇, 等. 顯微鏡下精索靜脈結扎術治療非梗阻性無精子癥伴精索靜脈曲張的療效與安全性. 中華醫學雜志, 2018, 98(46): 3737-3740.
11.	趙小東, 劉琳, 馬鵬程, 等. 顯微鏡下精索靜脈結扎術治療男性不育伴精索靜脈曲張患者的療效比較. 國際泌尿系統雜志, 2018, 38(5): 798-800.
12.	陳相軍, 宋應寒, 陳敏, 等. 四川大學華西醫院日間手術質量和安全管理規范. 華西醫學, 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.	范曉猛, 朱紅偉, 朱志敏, 等. 不同手術方式治療精索靜脈曲張對睪丸功能的影響. 國際泌尿系統雜志, 2022, 42(3): 524-527.
22.	郭澤信, 韓大愚, 楊其運, 等. 加速康復外科理念在精索靜脈曲張高位結扎手術中的應用. 廣東醫學, 2019, 40(17): 2478-2482.
23.	國際日間手術協會, 中國日間手術合作聯盟. 日間手術發展與實踐. 北京: 人民衛生出版社, 2016: 18, 49.
24.	白雪, 馬洪升, 羅利. 中外日間手術發展對比研究及展望. 中國醫院管理, 2014, 34(5): 35-37.
25.	何瓊, 張靜, 周維強, 等. 湖南省某院日間手術實施現狀分析. 中國病案, 2017, 18(2): 56-59.
26.	劉云龍, 谷現恩, 張曉毅, 等. 精索靜脈曲張所致陰囊疼痛經手術治療緩解的影響因素 Meta 分析. 中華男科學雜志, 2017, 23(6): 550-560.
27.	王冠群, 周立新. 精索靜脈顯微結扎術治療原發性精索靜脈曲張的療效觀察. 中國性科學, 2019, 28(3): 51-54.
28.	楊永毅, 黃偉, 曹俊杰, 等. 結扎睪丸引帶靜脈對顯微精索靜脈曲張手術療效的影響. 中華男科學雜志, 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, 張志超, 等. 精索靜脈曲張或無精子癥男性的睪酮水平. 北京大學學報(醫學版), 2022, 54(2): 294-298.
3. 劉金炳, 陳智毅. 不育癥患者精索靜脈曲張程度超聲分級與精液質量和性激素的相關性研究. 中國生育健康雜志, 2021, 32(5): 474-476.
4. 李志國, 蘇剛嶺, 劉石勇, 等. 不同手術方式治療精索靜脈曲張不育臨床效果及與患者年齡的關系. 中國計劃生育學雜志, 2022, 30(7): 1626-1630.
5. 黃健, 鐘光俊. 精索靜脈曲張的手術治療進展. 國際泌尿系統雜志, 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. 王艷, 呂曉輝, 田莽, 等. 腹腔鏡與顯微鏡外環下精索靜脈結扎術治療官兵精索靜脈曲張效果觀察. 人民軍醫, 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. 田汝輝, 陳慧興, 趙亮宇, 等. 顯微鏡下精索靜脈結扎術治療非梗阻性無精子癥伴精索靜脈曲張的療效與安全性. 中華醫學雜志, 2018, 98(46): 3737-3740.
11. 趙小東, 劉琳, 馬鵬程, 等. 顯微鏡下精索靜脈結扎術治療男性不育伴精索靜脈曲張患者的療效比較. 國際泌尿系統雜志, 2018, 38(5): 798-800.
12. 陳相軍, 宋應寒, 陳敏, 等. 四川大學華西醫院日間手術質量和安全管理規范. 華西醫學, 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. 范曉猛, 朱紅偉, 朱志敏, 等. 不同手術方式治療精索靜脈曲張對睪丸功能的影響. 國際泌尿系統雜志, 2022, 42(3): 524-527.
22. 郭澤信, 韓大愚, 楊其運, 等. 加速康復外科理念在精索靜脈曲張高位結扎手術中的應用. 廣東醫學, 2019, 40(17): 2478-2482.
23. 國際日間手術協會, 中國日間手術合作聯盟. 日間手術發展與實踐. 北京: 人民衛生出版社, 2016: 18, 49.
24. 白雪, 馬洪升, 羅利. 中外日間手術發展對比研究及展望. 中國醫院管理, 2014, 34(5): 35-37.
25. 何瓊, 張靜, 周維強, 等. 湖南省某院日間手術實施現狀分析. 中國病案, 2017, 18(2): 56-59.
26. 劉云龍, 谷現恩, 張曉毅, 等. 精索靜脈曲張所致陰囊疼痛經手術治療緩解的影響因素 Meta 分析. 中華男科學雜志, 2017, 23(6): 550-560.
27. 王冠群, 周立新. 精索靜脈顯微結扎術治療原發性精索靜脈曲張的療效觀察. 中國性科學, 2019, 28(3): 51-54.
28. 楊永毅, 黃偉, 曹俊杰, 等. 結扎睪丸引帶靜脈對顯微精索靜脈曲張手術療效的影響. 中華男科學雜志, 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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