Microsurgical Subinguinal or Laparoscopic Palomo Varicocelectomy in adolescent patients, which technique is better?

Yıl 2025, Cilt: 47 Sayı: 3, 346 - 351, 02.05.2025

Dilşad Dereli , İyimser Üre , Utku Bekyürek , Baran Tokar

https://doi.org/10.20515/otd.1573590

Öz

The indications for surgical intervention in adolescent varicocele cases are restricted. When intervention is necessary, treatment options include the open subinguinal approach, laparoscopic surgery, or embolization. This study aimed to compare outcomes between microsurgical sub-inguinal varicocelectomy and laparoscopic varicocelectomy in adolescent patients. Forty-nine patients under 18 years old who underwent varicocelectomy between 2010 and 2023 were categorized into two groups based on the surgical approach 19 patients underwent laparoscopic varicocelectomy by pediatric urologists, and 30 patients underwent SV by the urology department. Patient records were retrospectively analyzed for age, preoperative symptoms, physical examination findings, ultrasound results, surgical techniques, and postoperative outcomes. There was no significant difference in recurrence rates between subinguinal varicocelectomy and laparoscopic varicocelectomy techniques. However, statistically significant differences were noted in operative duration, hospital stay length, and patient age at the time of surgery between the pediatric urology and urology department groups employing different techniques. Both subinguinal varicocelectomy and laparoscopic varicocelectomy techniques can be considered based on the surgeon's expertise and institutional resources. Regardless of the approach chosen, preserving arterial and lymphatic structures to maintain testicular blood supply and minimize complications is paramount.

Anahtar Kelimeler

Varicocele , ,Laparoscopic Palomo , Microsurgecal Varikoselectomy

Adölesan Hastalarda Mikrocerrahi Subinguinal veya Laparoskopik Palomo Varikoselektomi, Hangi Teknik Daha İyidir?

Öz

Adölesan varikosel vakalarında cerrahi müdahale endikasyonları kısıtlıdır. Müdahale gerekli olduğunda, tedavi seçenekleri arasında açık subinguinal yaklaşım, laparoskopik cerrahi veya embolizasyon yer almaktadır. Bu çalışmada adolesan hastalarda mikrocerrahi subinguinal varikoselektomi (SV) ve laparoskopik varikoselektomi (LV) sonuçları karşılaştırıldı. 2010-2023 yılları arasında varikoselektomi uygulanan 18 yaş altı 49 hasta cerrahi yaklaşıma göre iki gruba ayrıldı. 19 hastaya pediatrik ürologlar tarafından SV, 30 hastaya üroloji bölümü tarafından SV uygulandı. Hasta kayıtları yaş, ameliyat öncesi semptomlar, fizik muayene bulguları, ultrason sonuçları, cerrahi teknikler ve ameliyat sonrası sonuçlar açısından retrospektif olarak analiz edildi. SV ve LV teknikleri arasında nüks oranları açısından anlamlı bir fark yoktu. Bununla birlikte, farklı teknikler kullanan çocuk ürolojisi ve üroloji bölümü grupları arasında ameliyat süresi, hastanede kalış süresi ve ameliyat sırasındaki hasta yaşı açısından istatistiksel olarak anlamlı farklılıklar kaydedildi. Cerrahın uzmanlığına ve kurumsal kaynaklara bağlı olarak hem SV hem de LV teknikleri düşünülebilir. Seçilen yaklaşım ne olursa olsun, testiküler kan akımını sürdürmek ve komplikasyonları en aza indirmek için arteriyel ve lenfatik yapıları korumak çok önemlidir.

Anahtar Kelimeler

Varikosel , Palomo Varikoselektomi , Subinguinal Mikrocerrahi Varikoselektomi

Kaynakça

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