Naslov
Internal spermatic to superficial epigastric venous anastomosis in the treatment of varicocele in pediatric patients

Autori
Papeš, Dino ; Ćavar, Stanko ; Sabolić, Ivana ; Pasini, Miram ; Škrljak Šoša, Dora ; Dalipi, Aida ; Jelčić, Ivan ; Vlahek, Tomislav ; Antabak, Anko ; Luetić, Tomislav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
9th Croatian Congress of Pediatric Surgery with International Participation - Book of abstracts / - , 2022, 62-62

Skup
9th Croatian Congress of Pediatric Surgery with International Participation

Mjesto i datum
Pula, Hrvatska, 21.09.2022. - 24.09.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
varicocele ; microsurgical ; bypass ; venous

Sažetak
During microsurgical varicocelectomy all external and internal spermatic veins are ligated at the external inguinal ring level, with preservation of the spermatic artery and lymphatic ducts. This minimizes the chance for recurrence, hydrocele or testicular atrophy. During dissection of pampiniform veins from the artery, vasospasm may occur, making the identification of artery difficult or impossible, even after application of local vasodilatators or with the use of micro Doppler. In such situation it, only dilated spermatic veins can be ligated, non-dilated veins left intact, and recurrence prevented by forming a internal testicular vein to superficial epigastric vein microanastomosis. Such bypass allows diversion of any remaining reflux towards the saphenous bulb thorough interconnecting pampiniform collaterals. This is a prospective analysis of all patients that underwent microsurgical varicocelectomy with spermatic-epigastric vein anastomosis at the Department of Pediatric Surgery University Hospital Center Zagreb from 2020 to 2022. The anastomosis patency was verified clinically during surgery, and by Doppler augmentation test 1, 6 and 12 months postoperatively. Results: overall 14 patients underwent spermatic-epigastric vein anastomosis. Average operative time was 65 minutes. All patients were discharged within 24 hours and no antiplatelet or anticoagulant agents were administered. No recurrence or postoperative complications were noted, and postoperative semen analysis was normal in all patients operated due to preoperative abnormal finding. All anastomoses were patent on control Doppler evaluation. Spermatic-epigastric anastomosis is a logical and safe choice to reduce the possibility of recurrence if non-dilated spermatic vein(s) cannot be distinguished from the spermatic artery due to vasospasm, and have to be left non-ligated.

Izvorni jezik
Engleski

POVEZANOST RADA