Clinical Anatomy Of External Spermatic Vessels And Clinical Significance Of Preserving The External Spermatic Artery

Objective: 1.To explore the clinical anatomy of external spermatic cord vessels by autopsy.2.Through statistical analysis of the clinical data,the clinical significance of retaining the external spermatic artery in the microsurgical treatment of varicocele of spermatic.Method: 1.By dissecting male cadavers in Ningxia Medical University,to clarify the clinical anatomy of external spermatic vessels.2.Case-control study: collect between April2016 and April 2017,General Hospital Ningxia Medical University microsurgery in the treatment of varicocele patients(n = 117),according to the strict into the exclusion criteria,pick out young patients with unilateral varicocele(n = 105),And according to the microscopical operation the different treatment methods of external spermatic vessels were divided into a,b two groups.Put forward testis and ligat external spermatic vessels under the naked eye.(A 41 cases)And preservation of external spermatic artery by ligation of the external spermatic vein under microscope.(B 64 cases),through the statistical analysis of two groups of clinical data and compared two groups of operation time,length of hospital stay,complications and recurrence of difference.3.Prospective study: formulating surgical methods,Preservation of external spermatic artery by ligation of the external spermatic vein under microscope(C).No put forward testicular and ligation of spermatic cord external vascular group(D).Collect from April 2017 to January 2018,a total of 121 patients with varicocele treated by microsurgery in General Hospital Ningxia Medical University were collected.According to the strict inclusion and exclusion criteria,patients with simple left side(98)were selected,including group C(53 cases)and group D(45 cases).The two groups in theoperation time,the time of hospitalization,postoperative complications(scrotal pain,testicular atrophy,scrotal edema)and the recurrence of the status were statistically compared.Results: 1.Through dissection of 6 male cadavers,it was found that the external spermatic artery was derived from the branch of the external iliac artery-the inferior epigastric artery,and the spermatic artery was concomitant with spermatic cord and terminate for testis sheath.Extraventory spermatic vein from the testis sheath,along with spermatic cord into the inferior abdominal vein,eventually into the external iliac vein.2.Analysis and comparison of A?B two sets of clinical data,patients with left scrotal pain occurred in group B after the operation rate of 12.5% was significantly lower than that in group A was 31.71%,the difference was statistically significant(P<0.05);and the remaining differences were not statistically significant.(p>0.05)3.The clinical data of C?D two groups were compared and analyzed.There was no statistically significant difference between the two groups.(P>0.05).Conclusion:1.The spermatic cord external arteries and the spermatic cord external veins belong to the branches of the inferior epigastric artery and the inferior epigastric vein,and they converge through the venous network in the testicular sheath.2.In the treatment of varicocele with microscope,there is no obvious advantage in preserving the external spermatic artery than not preserving in the external spermatic artery.3.When microsurgery is used to treat varicocele,not put forward testicular to ligation of the external spermatic vessels is superior than put forward testicular to ligation of the external spermatic vessels,which can reduce the incidence of scrotal pain after operation.