Laparoscopic treatment of varicoceles in children. Multicentric prospective study of 90 cases.

Details

Serval ID
serval:BIB_6B7851A9FBC7
Type
Article: article from journal or magazin.
Collection
Publications
Title
Laparoscopic treatment of varicoceles in children. Multicentric prospective study of 90 cases.
Journal
European Journal of Pediatric Surgery
Author(s)
Varlet F., Becmeur F.
ISSN
0939-7248
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
11
Number
6
Pages
399-403
Language
english
Abstract
PURPOSE: The aim of this study was to assess the results of the laparoscopic treatment of varicoceles. MATERIAL AND METHODS: 92 observations were received, however 5 patients underwent a simultaneous associated open surgery; 90 varicoceles were evaluated (3 bilateral varicoceles). The dilated spermatic veins were treated by clips and partial resection in 74.7 %, by coagulation and partial resection in 21 %, and by clips in 4.3 %. The spermatic artery was ligated in 60 varicoceles and preserved in 28; in 2 cases it was not specified. The results were studied with a mean follow-up of 11.1 months (2 to 36 months). RESULTS: The varicocele disappeared in 76 cases (84.4 %) and diminished significantly in 12 cases (13.2 %) where it was large before treatment. Two middle-sized varicoceles were not modified by the treatment. Therefore, the results must be considered good or excellent in 97.6 % of cases. The spermatic artery was preserved in 28 cases and the size of the varicocele was not good in 9 (32.1 %); it was ligated in 60 cases and the size of the varicocele was not good in 5 cases (8.4 %) -- p < 0.01. In 42 cases the testicular size was noted before and after treatment, and likewise the conservation or not of the spermatic artery; the 30 artery ligations produced no testicular atrophy; only 3 hypotrophic testes were noted with a loss of size of between 8.4 and 59 % with regard to the contralateral testis. In 27 cases, the testicular size remained normal or increased if it was hypotrophic before treatment; there was a good result in 90 % of cases with no atrophy. When the spermatic artery was preserved (12 cases), 1 hypotrophy occurred with a loss of size of 16.7 % -- NS. CONCLUSION: The laparoscopic treatment of varicoceles is an efficient technique and the complete ligation of the whole vascular spermatic pedicle above the vas deferens offers excellent success, without atrophy.
Keywords
Adolescent, Child, Follow-Up Studies, Humans, Laparoscopy, Male, Prospective Studies, Varicocele/surgery
Pubmed
Web of science
Create date
06/03/2008 15:09
Last modification date
20/08/2019 15:25
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