|
KMID : 1218220110030010029
|
|
Korean Journal of Pediatric Urology
2011 Volume.3 No. 1 p.29 ~ p.33
|
|
|
The Effectiveness of Laparoscopic Varicocelectomy in Adolescents and the Impact of Internal Spermatic Artery Preservation on the Treatment Results
|
|
Park Sung-Chan
Kim Dae-Young
Lee Chun-Woo
Kim Kun-Suk
|
|
|
Abstract
|
|
|
Purpose: We investigated the effectiveness of laparoscopic varicocelectomy. Surgical outcomes and a treatment algorithm measuring recurrence after laparoscopic varicocelectomy including internal spermatic artery (ISA) were also analyzed.
Materials and Methods: We retrospectively analyzed the data from 41 adolescents with left varicoceles who underwent laparoscopic varicocelectomy between December 1998 and January 2010. The mean age of the patients was 12.6 years (range: 10-16 years). Pre-operative and post-operative testis volumes were measured with an ellipsoid Prader orchidometer. Patients age, grades of varicocele, number of ligation veins, catch-up growth, and recurrence rates were analyzed between the ISA-sparing and ligation groups. The median follow-up period was 30 months. Patients with persistent or recurrent varicoceles were treated with embolization.
Results: ISA-sparing procedures were performed in 25 adolescents (61%). There were no significant differences in age, grades, number of ligation veins, and catch-up growth between the groups. Patients who had undergone the artery-sparing method had higher recurrence rates compared to those who had undergone the non-artery sparing method. However, these differences were not statistically significant. Seven adolescent patients had persistent or recurring varicoceles. Based on angiography findings, all patients were treated with embolization and no recurrence was observed.
Conclusions: Laparoscopic varicocelectomy was found to be a safe and effective method for treating pediatric varicoceles. Attempts should be made to preserve the ISA. If recurrence occurs, embolizaton is recommended as a secondary treatment modality. Further studies with a larger patient population should be conducted to confirm our the results of our study.
|
|
|
KEYWORD
|
|
|
Varicocelectomy, Laparoscopy, Adolescent, Embolization
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|