AI Article Synopsis

  • The study analyzed the effectiveness and complications of laparoscopic varicocelectomy in children, involving 211 participants aged 6-17, with most cases being unilateral on the left side.
  • The average surgery time was 30 minutes with a 24-hour hospital stay; complications arose in 9% of cases, primarily hydrocele, but there were no instances of testicular atrophy.
  • Results indicated that laparoscopic methods yield comparable outcomes to open surgery, with a preference for ligating both testicular veins and arteries to minimize complications.

Article Abstract

Background: The aim of this study was to evaluate the results and complications of laparoscopic varicocelectomy in children.

Methods: Over a 36-month period, 211 children underwent laparoscopic treatment of varicocele. Their ages ranged between 6 and 17 years; the varicocele was located on the left side in 209 cases (99.1%) and was bilateral in 2 (0.9%). In 195 patients the laparoscopic transperitoneal approach was used and in 16 retroperitoneoscopy was used. Thirty children (14.2%) underwent ligation of the veins alone, and 181 (85.8%) underwent ligation of testicular veins and artery. In 15 (7.1%) cases an additional procedure was applied during the same operation.

Results: Average operating time was 30 minutes and hospitalization about 24 hours. At an average follow-up of 26 months, there were 19 (9%) postoperative complications: 14 children had a left hydrocele, 3 children a scrotal emphysema, and 2 an umbilical granuloma. There were 5 recurrences of varicocele in our series: 2 (2 of 30, 6.6%) after the Ivanissevitch procedure, and 3 (3 of 181, 1.6%) after Palomo's. Testicular atrophy did not occur in any patient of this series.

Conclusions: This preliminary experience shows that the results of the laparoscopic approach are comparable to those of the open approach. The ligation of testicular veins and artery is preferable to the ligation of the testicular veins alone. Hydrocele seems to be the most frequent postoperative complication and a potential problem, especially in children operated on with the Palomo procedure.

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Source
http://dx.doi.org/10.1053/jpsu.2001.22956DOI Listing

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