Tratamiento laparoscópico del varicocele en adolescentes
- I. Simal
- A. Parente Hernández
- Silvia García Saavedra
- Marcos Prada Arias
- L. Burgos
- R. Ortiz
- Javier Gómez Veiras
- M. Montero
- J. M. Angulo
ISSN: 0001-6640
Ano de publicación: 2019
Volume: 77
Número: 5-6
Páxinas: 119-128
Tipo: Artigo
Outras publicacións en: Acta pediátrica española
Resumo
Background: There are several surgical and radiologic treatment options for varicocele repair. At two institutions we perform the Palomo technique with laparoscopic approach without sparing the testicular artery. Our purpose is to review our experience in the treatment of varicocele assessing recurrence and secondary hydrocele rate, comparing them with other techniques in the literature. Material and methods: Observational retrospective review of patients under 16 years old treated with laparoscopic not selective ligation of spermatic vessels between 2009 and 2013 at our institutions. Results: Ninety-eight patients were included in this study (mean age 13.4 years). Every case was unilateral left varicocele and the indications were testicular hypotrophy (39.8%), high degree (46.9%) and pain (4.1%). All patients underwent laparoscopic not selective ligation of spermatic vessels. The mean operating time was 45 minutes and the mean postoperative hospital stay was 16 hours. There was no conversion. Ten patients (10.2%) required a second surgical procedure because of secondary hydrocele. Two patients (2%) suffered a residual varicocele, one of them without clinical relevance and the other one required another surgery. Conclusions: 1) High grade should be reconsidered as a surgical indication; 2) our results are similar to those published in the literature regarding laparoscopic Palomo and are superior to inguinal approaches, and 3) the laparoscopic Palomo technique offers the best treatment option for varicoceles, due to the good outcome and the acceptable percentage of secondary hydrocele.