| Objective:To analyze the curative effect of two surgical methods for the treatment of primary varicocele,transcatheter internal spermatic vein embolization and traditional high spermatic vein ligation,and to discuss the advantages and disadvantages of the two treatment methods and the occurrence of complications by comparing the results,so as to provide certain guidance for the selection of surgical methods for clinicians.Methods:The clinical data of 71 patients with primary left varicocele in the First Affiliated Hospital of Nanchang University from June 2018 to September 2019 were collected.According to different surgical methods,they were divided into sclerosing agent group and high ligation group,of which 30 cases were sclerosing agent group and 41 cases were high ligation group.The surgical treatment of the sclerosing agent group was transcatheter internal spermatic vein injection with foam sclerosing agent,and the surgical treatment of the high ligation group was traditional high ligation of retroperitoneal spermatic vein(Palomo operation).The perioperative data of the two groups were statistically analyzed and compared.Results:All 71 patients successfully completed the corresponding surgical treatment.No ectopic embolism(pulmonary embolism,etc.)occurred in the sclerosis group,and no serious complications such as spermatic cord injury and important artery injury occurred in the high ligation group.All patients in the two groups felt that their symptoms were improved.There was no statistically significant difference between the sclerosing agent group and the high ligation group in preoperative basic data such as age and clinical grading composition of spermatic vein(P>0.05).Patients in the hardener treatment group were mostly treated with polypolycarol foam hardener(1:3or 1:4 with air)at the dosage of 4-7(5.05±1.05)ml;In addition,The operative time(32.1±11.1 min VS50.41±4.48 min),hospitalization time(3.66±0.59 days VS4.0±2.02 days)and treatment cost(10948.29±2547.00 yuan VS9634.11±885.97yuan)were statistically significant between the sclerosis agent group and the high ligation group(P<0.05).In terms of complications,the incidence of postoperative infection or hematoma at the puncture point(incision)in the sclerosis agent group was 3.33%,the rate of postoperative feeling of scrotal swelling was 6.67%,and the rate of postoperative hydrophosis was 10.9%,which was lower than that in the high ligation group(7.31%,21.95%,39.02%,respectively).Chi-square test showed that the comparison between the two was statistically significant(all P < 0.05).After 12 months of follow-up,there was no recurrence in the sclerosing agent group and 1 in the high ligation group,with a recurrence rate of 2.43%.There was no significant statistical significance in the recurrence rate of varicocele between the two groups(P > 0.05).Conclusions:Patients treated with sclerotherapy have shown the advantages of shorter surgery time,fewer hospital stays,less trauma,and a lower incidence of complications compared with high-grade ligation,but the cost is relatively higher.Therefore,the development of treatment methods for primary varicocele is gradually moving towards minimally invasive interventional therapy,and transcatheter foam sclerotherapy may become the first choice of treatment for primary varicocele patients. |
