| Objectives: The objective of this paper is to provide the reference forselecting the best operation scheme for the male patients with inguinal herniawho is unmarried,childless or still have the fertility requirements and theclinician through the contrast of the each index in male patients representedthe reproductive function in different period after TEP to understand thedegree of the influence on the reproductive function after operation.Methods: Select 34 cases(33 to 62 years old)with easily repositionedunilateral inguinal hernia, including the left and right the indirect inguinalhernia and direct inguinal hernia. All the patients were admitted to thegastrointestinal surgery of the Second Hospital of Hebei Medical Universitysince April 2013 to April 2014 and underwent laparoscopic TEP,The mode ofanesthesia were tracheal intubation general anesthesia. The patching materialis 15×10cm polyester anatomical inguinal hernia patch produced by the TycoCompany(USA). By observing the followed indexes at the 1 day beforesurgery,4th week and 24 th week after surgery: 1 WBC in blood routine;2 theconcentration of serum testosterone; 3 the testicular temperature;4 thetesticular volume;5 the diameter of testicular artery,the systolic peak of BFR,the end-diastolic BFR and the resistance index in testicular artery;6 thediameter of spermatic vein, the BFR in the spermatic vein and others. Allanalyses were performed by using SPSS version 19(IBM SPSS Statistics,IBM Corporation, Armonk, New York).We compared the experimental dataobtained in the patient’s health side and the other side before and after surgery.Results for measurement data are expressed as mean±SD, while one-wayANOVA are used in comparison of difference, and values P<0.05 wereregarded as statistically significant.Results: A total of 34 cases were enrolled, including two postoperativepatients were lost at 24 th week, and one appeared postoperative infection. Theremaining data from 31 patients are analyzed as follows:1 The 4th week postoperative WBC were increased than preoperativeWBC[(6.27±0.22)×109/L vs.(5.33±0.20)×109/L; P=0.008],but it is still in thenormal range[(4~10)×109/L],while 24 th week postoperatively WBC wassimilar to the preoperative [(5.48 + 0.23) x 109/L vs.(5.33 + 0.20) x 109/L; P= 0.900), the difference is not significant(P>0.05).2 Both the 4th week and 24 th week postoperative concentration of serumtestosterone are similar to the preoperative(3.70±0.23ng/ml, 3.60±0.20ng/mland 3.89±0.23ng/ml),there is no statistically significant.3 Compared the preoperative and 1th week and 24 th week postoperativeindexes in patients, including the testicular temperature, the testicular volume,the diameter of testicular artery, the systolic peak of BFR, the end-diastolicBFR and the resistance index in testicular artery, the diameter of spermaticvein, the BFR in the spermatic vein, there is no significant differences(P>0.05). The same result came out in the healthy testis.4 The comparision of testicular volume in the first day before surgeryand 4 weeks after surgery, and postoperative 24 weeks. postoperative 4 zhoujian contralateral testicular volume compared with the preoperative[(15.50+0.26) cm3 vs(15.55+0.26) cm3; P=0.999), postoperative 24 zhoujian contralateral testicular volume compared preoperative [(15.92+0.39) cm3vs(15.55+0.26) cm3; P= 0.812), after 4 weeks of testicular volume comparedwith the preoperative [(15.74+0.30) cm3 vs(15.7+0.31) cm3; P= 1.000),postoperative 24 weeks of testicular volume compared with the preoperative[(15.42+0.44) cm3 vs(15.71+0.31) cm3; P= 0.927), the contralateral side andtesticular volume preoperative and postoperative difference(P>0.05, nostatistical significance.5 Patients with bilateral testicular artery diameter and blood flowresistance at the same time, the peak systolic blood flow velocity, arteryend-diastolic blood flow velocity and blood flow velocity of spermatic veindiameter, spermatic vein 1 day before surgery, postoperative 4 weeks, and nostatistically significant difference were observed in the 24 weekspostoperatively(P>0.05), while the contralateral testicular temperature,patients with testicular volume, testicular artery diameter and blood flowresistance, systolic peak velocity, artery end-diastolic diameter and blood flowvelocity of blood flow velocity and spermatic vein differences also had nostatistical significance(P>0.05).Conclusions:1 There are no significant difference between the serum testosteroneconcentration,temperature of the ipsilateral testicles, testicular volume,testicular artery(diameter, blood flow resistance, artery systolic velocity,artery diastolic velocity), spermatic vein(pipe diameter and flow velocity).2 That laparoscopic totally extraperitoneal inguinal hernia repair(TEP)surgery itself effect on male reproductive function in patients with small, butlaparoscopic totally extraperitoneal inguinal hernia repair(TEP) surgery forpatients with the structure and function of the vas deferens effect remains tobe further studied and summarized. |
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