정계정맥류의 수술적 치료에 있어서 서혜부를 통한 Palomo방법
Modified Inguinal Palomo Technique in Surgical Repair of Varicocele
이재현, 나용길, 권지순,
소속 상세정보
이재현 ( )
충남대학교 의과대학 비뇨기과학교실
나용길 ( )
충남대학교 의과대학 비뇨기과학교실
권지순 ( )
충남대학교 의과대학 비뇨기과학교실
KMID : 0358319980390020178
Abstract
결론
저자들은 1996년 4월부터 1997년 3월까지 15명의 정계정맥류 환자에서 서혜부로 접근하는
Palomo방법을 이용하여 모든 환자에서 재발이 없었으며, 음낭수종이나 고환위축 등의 합병
증도 발생하지 않았다 따라서 서혜부로 접근하는 Palomo방법은 접근이 용이하며, 외복사근
및 내복사근을 분리하는 과정이 생략되므로 종래의 후복막을 통한 Palomo방법에 비해서 수
술 시간을 단축시킬 수 있고, 수술 후 재발 및 합병증이 적은 좋은 방법으로 사료된다.
#초록#
Purpose: A varicocele is the most common correctable cause of infertility in men.
Conventional techniques of varicocele repair are associated with substantial risks of
hydrocele formation, varicoele persistence and recurrence. The inguinal approach with
classic Palomo technique was used to be simplified the procedure and to get the same
good results with the Palomo technique.
Materials and Methods: From March 1990 to March 1997, we experienced surgical
corrections of 54 patients with varicocele(A mean age 20.3 years) The most of patients
were left-sided(96.3%). Until March 1996, surgical correction with Palomo(6 patients) and
modified Palomo(13 patients) technique by retroperitoneal approach and Ivanissevich
techrique(20 patients) by inguinal approach have been performed, and since April 1996,
Palomo technique(15 patients) with inguinal approach has been performed, in which the
entire vascular pedicle is ligated superior to the entrance of the was deferens through
the inguinal incision.
Results: The postoperative recurrences in the modified Palomo technique occurred In
two of the 13 patients(15%) and in the Ivanissevich technique in three of the 20
patients(15%). But there were no recurrences In the retroperitoneal Palomo and modified
inguinal Palomo techniques. The modified inguinal Palomo technique was completed
within 45.3minutes in mean duration, but the standard retroperitoneal Palomo technique
within 55.2minutes, modified Palomo technique within 57.2minutes and Ivanissevich
technique within 51.4minutes. There was no varicocele recurrence, hydrocele and atrophy
of testis in modified inguinal Palomo techniques.
Conclusions: The modified inguinal Palomo technique was easily approachable and
relatively fast in our experience and had no recurrence.
키워드
Varicocele; Palomo technique; Inguinal approach;
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