NDLI: Laparoscopic surgery of deferential reflux in pediatric and adolescent varicocele.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cimador, Marcello Di Pace, Maria R. Sergio, Maria Catalano, Pieralba Castagnetti, Marco De Grazia, Enrico
Description	Country affiliation: Italy Author Affiliation: Cimador M ( Department of Mother and Child Care, Università di Palermo, Palermo, Italy. mcimador@unipa.it)
Abstract	BACKGROUND: This study aimed to assess whether deferential reflux in pediatric and adolescent varicocele can be successfully treated laparoscopically. MATERIALS AND METHODS: Since 2001 at our institution, 148 boys were evaluated for a left varicocele. Preoperatively,all the patients underwent ultrasound scan assessment of testicular volume and color-Doppler US (CDUS)to rule out reflux into the internal spermatic vein (ISV), deferential vein, or cremasteric vein. Boys with ISV reflux were treated by laparoscopic transperitoneal Palomo; boys with isolated deferential reflux or associated to ISV reflux were laparoscopically managed adding to the former procedure, coagulation or clipping of refluxing deferential veins. RESULTS: Reflux in both the ISV and the deferential vein was observed in 21 (14.1%) out 148 boys with varicocele.Only one case (0.6%) of varicocele was caused by an isolated deferential reflux. No reflux in the cremasteric vein was observed. After a median follow up period of 2 years (range, 6 months-5 years), none of our patients with deferential reflux experienced varicocele recurrence either clinically or according to CDUS scanning.No testicular atrophy was observed. CONCLUSION: Our diagnostic approach is a rigorous standard for identifying all the venous systems concurring with the varicocele. Our proposed technique with laparoscopic interruption or coagulation of deferential veins when proved by CDUS to be refluxing may allow successful treatment for most varicoceles. This method allows reduction in recurrence of varicocele due to a missed deferential reflux.
File Format	HTM / HTML
ISSN	10926429
Issue Number	Suppl 1
Volume Number	19
e-ISSN	15579034
Journal	Journal of Laparoendoscopic & Advanced Surgical Techniques
Language	English
Publisher	Mary Ann Liebert, Inc.
Publisher Date	2009-04-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline General Surgery Laparoscopy Methods Varicocele Surgery Vas Deferens Physiopathology Adolescent Child Humans Male Ultrasonography Journal Article
Content Type	Text
Resource Type	Article
Subject	Surgery

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