Surgical retroperitoneoscopic and transperitoneoscopic access in varicocelectomy: duplex scan results in pediatric population.
OBJECTIVE
This is a retrospective study to compare duplex scan results of laparoscopic Palomo's technique through retroperitoneal and transperitoneal approach for varicocelectomy in children. We statistically analyzed recurrence, testicular volume growth and complications.


METHODS
Surgical intervention was performed utilizing transperitoneoscopic (group A) or retroperitoneoscopic access (group B). Duplex scan control was performed after 12 months (T1), after 2 years (T2) and the last one at 18 years old in most patients. Statistical analysis was performed using the t-test for parametric data. Differences in proportions were evaluated using χ2 or Fisher's exact test.


RESULTS
We treated 120 children (age range 10-17 years) who presented an asymptomatic IV grade of reflux, Coolsaet 1, associated with a left testicular hypotrophy in 36.6% of the cases (44 patients). No post-operative complications were verified. Duplex scan exam showed an increase of left testicular growth in both groups, with complete hypotrophy disappear in patients in both groups after 24 months. Hydrocele, diagnosed clinically and confirmed with duplex scan, was the most frequent post-operative complication (22/120 cases; 18.3%).


CONCLUSIONS
This study showed the importance of duplex scan at all steps of this vascular pathology in children, and that there is no significantly difference in results between the two surgical techniques except for hydrocele in transperitoneoscopic access.
Section of Phlebology, Department of General and Specialistic Surgery, University of Siena, 53100 Siena, Italy.
Stefano
S
Mancini
Section of Pediatric Surgery, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100 Siena, Italy. Electronic address: anna_lav82@yahoo.it.
Anna Lavinia
AL
Bulotta
Section of Pediatric Surgery, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100 Siena, Italy.
Francesco
F
Molinaro
Section of Pediatric Surgery, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100 Siena, Italy.
Francesco
F
Ferrara
Section of Phlebology, Department of General and Specialistic Surgery, University of Siena, 53100 Siena, Italy.
Giulio
G
Tommasino
Section of Pediatric Surgery, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100 Siena, Italy.
Mario
M
Messina
D000293:Adolescent; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010537:Peritoneum / Q000601:surgery; D012187:Retroperitoneal Space / Q000601:surgery; D012189:Retrospective Studies; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014646:Varicocele / Q000000981:diagnostic imaging* / Q000601:surgery*
Duplex scan; Laparoscopic approach; Varicocele