medigraphic.com
ISSN 2305-7939 (Electronic)

2018, Number 2

<< Back Next >>

RCU 2018; 7 (2)

Laparoscopic versus open varicocele surgical treatment in adolescents

Cárdenas SM, Castelló GM, Loret de Mola PE

Language: Spanish
References: 31
Page: 60-69
PDF size: 760.39 Kb.


ABSTRACT

Introduction: Minimum access surgery offers the possibility of treating adolescents with varicocele as an alternative to conventional open surgery. Objective: To evaluate the results of the surgical treatment of varicocele by laparoscopic and open ways in adolescents treated at "Eduardo Agramonte Piña" Pediatric Hospital of Camagüey from January 2013 to December 2014. Methods: A descriptive, longitudinal and prospective study was carried out, in which two groups of 32 patients each were formed: Group A (Palomo technique by open way) and Group L (Palomo technique by laparoscopic way). Each case was evaluated at one month, six months and one year after the surgery. Descriptive statistics were used and the means between the groups were compared using the chi-square test with a significance level of 95% (α = 0.05). Results: The mean age was 14.8 years old. 93.8% had varicocele on the left side and 73.4% of the total had a grade III in the classification, which was the main surgical indication. The surgical time was significantly shorter in Group L with an average of 17.1 minutes, and also for the return to usual activities (2.8 vs 4.4 days). Postoperative complications (persistence of varicocele and postoperative hydrocele) were higher in Group L but without significant differences. Conclusions: Laparoscopic varicocele surgery had longer surgical time, inpatient stay and postoperative recovery, while the frequency and type of complications were similar in both groups.


REFERENCES

  1. Castro SF, Castro AF. Varicocele en el niño. Rev Pediatr Elect. 2007;4(1):123-4.

  2. Gat Y, Zukerman ZV, Bachar GN, Feldberg DO, Gornish M. Adolescent varicocele: is it a unilateral disease? Urology. 2003;62(4):742-60.

  3. Thomas JC, Elder JS. Testicular growth arrest and adolescent varicocele: does varicocele size make a difference? J Urol. 2002;168(4 parte 2):1689-91.

  4. Becmeur F, Sauvage P. Should varicoceles be treated in the adolescent? How? J Chir. 2012;136(2):93-6.

  5. Huk J, Fryczkowski, Kaletka Z, Gabriel A, Polec R. Evaluation of fertility after surgery for varicocele in boys and adolescents. Wiad Lek. 2014;51(Suppl 3):68-70.

  6. Lenzi A, Gandini L, Bagolan P, Nahum A, Dondero F. Sperm parameters after early left varicocele treatment. Fertil Steril. 2015;69(2):347-9.

  7. Palomo A. Radical cure of varicocele by a new technique: preliminary report. J Urol. 1949;61:604-7.

  8. Calderón PV, Angulo MJ, Soto BC, Pérez RN, Ávila RL, Rodríguez-Alarcón GJ, et al. Evaluation of testicular growth after varicocele treatment in early childhood and adolescence based on the technique used (Palomo, Ivanissevich and embolization). Cir Pediatr. 2016;29(4):175.

  9. Kass E. Pediatric varicocele. En: O´Donnell and Koffs S. Pediatric Urology. 3ra edición. Oxford: Butterworth Heinemann; 1997.

  10. Zucchi A, Mearini L, Mearini E, Costantini E. Treatment of varicocele: randomized prospective study on open surgery versus Tauber antegrade sclerotherapy. Andrology. 2006;26(3):328.

  11. Guevara CJ, El-Hilal AH, Darcy MD. Percutaneous antegrade varicocele embolization via the testicular vein in a patient with recurrent varicocele after surgical repair. Cardiovasc Intervent Radiol. 2015;38(5):1325-9.

  12. Bautista A, Esteves E, Mendez-Gallart R, Rodríguez P, Toboada P, Armas A, et al. Hidrocele relativo tras Palomo laparoscópico en el varicocele pediátrico. Arch Esp Urol. 2010;63(7):532-6.

  13. Pini Prato A, Mac Kinlay GA. Is the laparoscopic Palomo procedure for pediatric varicocele safe and effective? SurgEndosc. 2012;20:660-4.

  14. Telkar S, Goudar BV, Lamani YP, Ambi U. Laparoscopic versus open varicocelectomy a prospective study. J ClinDiagn Res. 2012;6(2):271-3.

  15. Caravia Pubillones, Vela Caravia. Aplicabilidad de la Clasificación de Clavien y Dindo en las complicaciones quirúrgicas urológicas. Rev Cubana Urol. 2015;4(2):83-8.

  16. Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. FertilSteril. 1970;21:606-9.

  17. Al-Abbadi K, Smadi SA. Genital abnormalities and groin hernias in elementary-schoolchildren in Aqaba: an epidemiological study. East Mediter Health J. 2013;6:293-8.

  18. Belloli G, D Agostino S, Pesce C. Varicocele in childhood and adolescence and other testicular anomalies: an epidemiological study. Pediatr Med Chir 2013;15:159-62.

  19. Camoglio FS, Cervellione RM, Dipaola G. Idiopathic varicocele in children. Epidemiological study and surgical approach. Minerva Urol Nefrol. 2014;53:189-93.

  20. Shetty AS, Prabakaran B, Bharath A. A Clinical study and management of varicocele. Int J Science Res. 2016;5(4):1267-71.

  21. Gómez Beltrán O, Garrido Pérez JI, García Ceballos A, Escassi Gil A, Vargas Cruz V, Lasso Betancourt CE, et al. Cirugía abierta, Palomo laparoscópico y embolización en niños con varicocele. Cir Pediatr. 2014;26:9-12.

  22. Kass EJ, Belman AB. Reversal of testicular growthfailurebyvaricocele ligation. J Urol. 1987;137:475-6.

  23. Abdulkareem AH. Laparoscopic versus various types of open ligation of testicular veins for treatment of varicocele. World J Laparosc Surg. 2013;2(1):40-1.

  24. Youssef T, Abdalla E. Single incision transumbilical laparoscopic varicocelectomy versus the conventional laparoscopic technique: A randomized clinical study. Int J Surg. 2015;18:178-83.

  25. Maheshwari R, Mandia R, Malik P, Haldeniya K, Harish NL. Comparison of laparoscopic and open high ligation procedure. Global J Med Res: Surgeries and Cardiovascular System. 2014;XIV(5):22-6.

  26. Sangrasi AK, Leghari AA, Memon A, Talpur KA, Memon AI, Memon JM. Laparoscopic versus inguinal (Ivanissevich) varicocelectomy. J Coll Phys Surg Pakistan. 2015;20(2):106-11.

  27. Winfield HN, Donovan JF, See WA, Loening SA, Williams RD. Urological laparoscopic surgery. J Urol. 1991;146:941-4.

  28. Pastuszak AW, Kumar V, Shah A, Roth DR. Diagnostic and management approaches to pediatric and adolescent varicocele: a survey of pediatric urologists. Urology. 2014;84(2):450-6.

  29. Parrilli A, Roberti A, Escolino M, Esposito C. Surgical approaches for varicocele in pediatric patient. Transl Pediatr. 2016;5(4):227.

  30. Matsuda T, Horii Y, Higashi S, Oishi K, Takeuchi H, Yoshida O. Laparoscopic varicocelectomy: a simple technique for clip ligation of the spermatic vessels. J Urol. 1992;147:636-8.

  31. Mandressi A, Buizza C, Antonelli D, Chisena S. Is laparoscopy a worthy method to treat varicocele? Comparison between 160 cases of two-port laparoscopic and 120 cases of open inguinal spermatic vein ligation. J Endourol. 2016;10:435-41.




2020     |     www.medigraphic.com