Successful outcomes in adolescent varicocele treatment with high-level laparoscopic varicocelectomy

• Published in: Journal of pediatric surgery Vol. 55; no. 8; pp. 1610 - 1612
• Main Authors: Ulusoy, Oktay, Karakus, Osman Zeki, Ateş, Oğuz, Hakgüder, Faika Gülce, Olguner, Mustafa, Akgür, Feza Miraç
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020
• Subjects: Adolescent; Adolescent varicocele; Humans; Laparoscopic varicocelectomy; Laparoscopy; Ligation level; Male; Operative Time; Recurrence; Retrospective Studies; Testis - blood supply; Testis - surgery; Treatment Outcome; Varicocele - surgery; Vascular Surgical Procedures; Laparoscopic varicocelectomy; Ligation level; Adolescent varicocele
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2019.07.008

In this study, we aimed to compare the effects of testicular vein ligation level on complications encountered; i.e. high-level ligation cranial to the linea terminalis vs ligation caudal to the linea terminalis. A total of 47 unilateral adolescent patients, treated with laparoscopic varicocelectomy between January 2004 and December 2017, were reviewed retrospectively. Patients were divided into two groups in terms of ligation level: caudal to the linea terminalis as group 1 and cranial to the linea terminalis as group 2. Symptoms, varicocele grades, preoperative testicular growth arrest, operative method, hydrocele formation, postoperative recurrence and testicular catch-up growth were recorded. The mean operation time was 38.6 ± 10.2 min (34–53 min) in group 1 and was 33.6 ± 6.4 min (29–42 min) in group 2. Single hydrocele occurred in the laparoscopic nonselective varicocelectomy in group 1 (4.5%) and was successfully treated with open hydrocelectomy. Single varicocele recurrence was observed in the laparoscopic selective varicocelectomy in group 1 (4.5%) and treated with laparoscopic nonselective varicocelectomy cranial to the linea terminalis. The high-level ligation of the spermatic veins cranial to the linea terminalis during laparoscopic varicocelectomy, independent of the technique applied, may contribute to reasonable low hydrocele and recurrence rates. Level III.