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[Laparoscopic extraperitoneal high ligation of the spermatic vein for the treatment of varicocele].

Objective
To investigate the effect of laparoscopic extraperitoneal (LSEP) high ligation of the spermatic vein in the treatment of varicocele.


METHODS
We retrospectively analyzed the clinical data about 80 cases of varieocele, 48 treated by LSEP and the other 32 by laparoscopic transabdominal retroperitoneal (LSTR) high ligation of the spermatic vein. We recorded the semen parameters before and at 1, 3 and 6 months after surgery, intraoperative blood loss, operation time, postoperative complications, time of gastrointestinal function recovery and rate of pregnancy, followed by comparison of the data obtained between the two groups of patients.


RESULTS
Semen parameters were remarkably improved in both the LSEP and LSTR groups of patients postoperatively as compared with the baseline (P <0.05), but with no statistically significant difference at different postoperative months (P >0.05). The intraoperative blood loss was less in the LSEP than in the LSTR group (［8.3 ± 5.2］ vs ［9.1 ± 6.1］ ml, P >0.05), the operation time was shorter in the former than in the latter (［38.27 ± 9.23］ vs ［43.46 ± 11.72］ min, P >0.05), and so was the time of gastrointestinal function recovery (［1.27 ± 0.26］ vs ［2.43 ± 0.41］ d, P <0.05). No statistically significant differences were observed between the two groups during the 6- to 18-month follow-up in the rates of postoperative subcutaneous hematoma, scrotal and subcutaneous emphysema, recurrence, or pregnancy (P >0.05).


CONCLUSIONS
Laparoscopic extraperitoneal high ligation of the spermatic vein is safe and effective and has the advantage of quick recovery in the treatment of varicocele.