RESUMO
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Assuntos
Humanos , Masculino , Recém-Nascido , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/tratamento farmacológico , Hemangioma/diagnóstico por imagem , Hemangioma/tratamento farmacológico , Propranolol/uso terapêutico , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Diagnóstico Diferencial , Antibacterianos/uso terapêuticoRESUMO
OBJECTIVE: One of the complications after complete section of the spermatic pedicle in the treatment of adolescent idiopathic varicocele is the formation of a scrotal lymphocele. This can be avoided by preserving lymphatic vessels using dye, but there is a risk that dissection may be complicated in patients who have previously undergone embolization. The aim of this study was to determine whether prior embolization limits spermatic dissection. MATERIAL AND METHOD: We used lymphography with dye (Patent Blue) prior to surgery in order to mark and preserve the lymph vessels during spermatic section. This was done by laparoscopy with a single umbilical port. RESULTS: We treated six patients aged 12.5-15 years (mean 13.12 years), two of whom had grade 2 varicoceles and four grade 3. Prior percutaneous embolization with metallic coils had been undertaken in all cases but had not been curative. Post-surgery controls were undertaken for a mean duration of 5 months without any lymphoceles appearing. No testicles were lost, nor did any other complication arise. CONCLUSION: The presence of embolization material in the spermatic veins and perivascular fibrosis does not complicate surgery, enabling the single port laparoscopic technique to be undertaken.
