Adölesanlarda Açık ve Laparoskopik Varikoselektomi Sonuçlarının Karşılaştırılması

Abstract

Objectives: Varicocele occurs as a result of abnormal enlargement of the pampiniform plexus. Widely accepted treatment options are open or laparoscopic surgery and other interventional procedures. In this study, it was aimed to compare the results of the patients who underwent open and laparoscopic varicocelectomy. Materials and Methods: Children who were operated with the diagnosis of varicocele between 2006 and 2020 were included in the study. Children were divided into three groups according to different surgical methods such as laparoscopic surgery, open surgery with loop magnification and open surgery without loop magnification. Follow-up and treatment records of the patients were reviewed retrospectively. Charts of the patients were reviewed in terms of age, preoperative complaints, physical examination findings, radiologic imaging methods, operation method and postoperative outcomes. Results: When the surgical techniques applied to the patients are examined; open varicocelectomy was performed in 18 patients and laparoscopic varicocelectomy was performed in 15 patients. Postoperative subclinical or clinical recurrence was detected in eight patients, hydrocele in four and hematoma in one. There was no significant difference between the outcomes of open and laparoscopic varicocelectomy techniques in terms of recurrence. Postoperative hydrocele was observed in four (26.6 %) of the patients who underwent laparoscopic varicocelectomy. Hydrocele was not observed among the patients who underwent open varicocelectomy. Conclusion: There is no significant difference in terms of recurrence and complications in children who underwent open and laparoscopic varicocelectomy. The use of magnification in cases who underwent open varicocelectomy may reduce the rate of recurrence. Large series of randomized controlled prospective studies are needed for further comments.

Keywords

• Varicocele
• Laparoscopy
• Varicocelectomy

Adölesanlarda Açık ve Laparoskopik Varikoselektomi Sonuçlarının Karşılaştırılması

Abstract

Amaç: Varikosel pampiniform pleksusun anormal genişlemesi sonucu oluşur. Tedavi seçenekleri açık veya laparoskopik cerrahi ve girişimsel işlemlerdir. Bu çalışmada açık ve laparoskopik varikoselektomi yapılan hastaların karşılaştırılması amaçlandı. Gereç ve Yöntem: Çalışmaya 2006-2020 yılları arasında varikosel nedeni ile ameliyat edilmiş çocuk ve adoölesan 33 hasta dahil edildi. Hastalar uygulanan ameliyat yöntemine göre, laparoskopik, loop büyütme ile açık ve loop büyütme kullanılmadan açık olacak şekilde gruplandırıldı. Hastaların takip ve tedavi kayıtları geriye yönelik incelendi. Hastaların yaş, ameliyat öncesi şikayet, muayene bulguları, ultrasonografi bulguları, ameliyat yöntemi ve ameliyat sonrası şikayet, muayene bulguları, ultrasonografi bulguları kayıt edildi. Bulgular: Hastalara uygulanan ameliyat teknikleri incelendiğinde; 18 hastaya açık varikoselektomi, 15 hastaya ise laparoskopik varikoselektomi uygulandığı saptandı. Toplam sekiz hastada subklinik veya klinik nüks, komplikasyon olarak dört hastada hidrosel bir hastada hematom saptandı. Açık ve laparoskopik varikoselektomi teknikleri arasında nüks açısından anlamlı bir fark saptanmadı. Laparoskopik varikoselektomi yapılan hastaların 4’ünde (%26,6) hidrosel saptandı. Açık varikoselektomi yapılan hastalar arasında hidrosel izlenmedi. Sonuç: Açık ve laparoskopik varikoselektomi yapılan olgularda nüks ve komplikasyon olarak anlamlı fark olmamakla birlikte, açık varikoselektomi yapılan olgularda büyütme kullanılması nüks ve hidrosel oranını azaltabilir. Bunun için geniş serili randomize kontrollü prospektif çalışmalar yapılması gerekmektedir.

Keywords

• Varikosel
• Laparoskopi
• Varikoselektomi

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