Abstract
Background and Purpose
: Varicocele is a frequent problem (6% before age 10 years and 16% to 20% from 11 to 18 years) in pediatric surgery. Laparoscopic treatment is proposed as beneficial alternative to Ivanissevich's procedure. The present study aimed at comparing the early and late benefits of laparoscopy and open surgery.
Patients and Methods
: The overall series consisted of 76 patients undergoing laparoscopic spermatic vessel clipping and transection (L group) and an equal number of patients treated by a modified Ivanissevich procedure (S group). The diagnosis was second-degree varicocele associated with symptoms or hypotrophic testis in 35% and third-degree left varicocele in 65%. The mean age was 13.1 (range 6-19) and 11.9 years (range 8-17) in the S group and L group, respectively.
Results
: The mean hospitalization time was 40 hours in the S group (range 26-72 hours) and 13.9 hours in the L group (range 9-26 hours). The prevalence of minor postoperative complications was equally low in both groups (2%). At 1-year follow-up, varicocele persisted in 22% of the patients in the S group and in 3% of the L group. Secondary hydrocele occurred in three patients (4%) of the S group and in seven patients (9%) of the L group.
Conclusion
: From our data, the major benefit for laparoscopic high clipping of the vascular spermatic pedicle was the significantly lower recurrence rate than was seen after open surgery.
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