title: Laparoscopic treatment of varicoceles in children. Multicentric prospective study of 90 cases.
abstract: OBJECTIVE
  The aim of this study was to assess the results of the laparoscopic treatment of varicoceles.
  
  
  METHODS
  92 observations were received, however 5 patients underwent a simultaneous associated open surgery; 90 varicoceles were evaluated (3 bilateral varicoceles). The dilated spermatic veins were treated by clips and partial resection in 74.7 %, by coagulation and partial resection in 21 %, and by clips in 4.3 %. The spermatic artery was ligated in 60 varicoceles and preserved in 28; in 2 cases it was not specified. The results were studied with a mean follow-up of 11.1 months (2 to 36 months).
  
  
  RESULTS
  The varicocele disappeared in 76 cases (84.4 %) and diminished significantly in 12 cases (13.2 %) where it was large before treatment. Two middle-sized varicoceles were not modified by the treatment. Therefore, the results must be considered good or excellent in 97.6 % of cases. The spermatic artery was preserved in 28 cases and the size of the varicocele was not good in 9 (32.1 %); it was ligated in 60 cases and the size of the varicocele was not good in 5 cases (8.4 %) -- p < 0.01. In 42 cases the testicular size was noted before and after treatment, and likewise the conservation or not of the spermatic artery; the 30 artery ligations produced no testicular atrophy; only 3 hypotrophic testes were noted with a loss of size of between 8.4 and 59 % with regard to the contralateral testis. In 27 cases, the testicular size remained normal or increased if it was hypotrophic before treatment; there was a good result in 90 % of cases with no atrophy. When the spermatic artery was preserved (12 cases), 1 hypotrophy occurred with a loss of size of 16.7 % -- NS.
  
  
  CONCLUSIONS
  The laparoscopic treatment of varicoceles is an efficient technique and the complete ligation of the whole vascular spermatic pedicle above the vas deferens offers excellent success, without atrophy.
authors.affiliation: Service de Chirurgie Infantile du Professeur Y. Chavrier-CHU-Hôpital Nord, Saint-Etienne, France. mnf.varlet@wanadoo.fr
authors.forename: F
authors.initials: F
authors.lastname: Varlet
authors.forename: F
authors.initials: F
authors.lastname: Becmeur
mesh_terms: D000293:Adolescent; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011446:Prospective Studies; D014646:Varicocele / Q000601:surgery*