改良的输精管单层显微吻合术与输精管全层吻合术疗效比较

The outcome of comparison of modified one - and full - layer microsurgical vasovasostomy

目的比较行改良输精管单层显微吻合术与全层显微吻合术的疗效。方法回顾性分析2003年6月－2010年7月40例输精管结扎男性患者行输精管吻合再通手术，单层吻合术17例，全层吻合23例，2个月后随访精液中有精子表示再通成功。结果输精管结扎时间〈36个月患者，再通后精液中都有精子存在。结扎时间为36—96个月，再通率分别为88％和91％，结扎〉96个月后手术，再通率更差。单层吻合的平均手术时间为96min，全层吻合手术时间平均为181min。结论大多数情况下，改良的单层输精管吻合简单，快速。对于大多数患者来说，两种手术方式再通成功率无明显差异，单层吻合术可作为首选治疗。

Objectives To compare the outcome of a modified one - layer and full - layer vasovasotomy （VV） in two groups of men undergoing vasectomy. Methods The patients undergoing a modified one - or full - layer VV between June 2003 and July 2010 were retrospectively reviewed. A successful outcome （patency） was de- fined as sperm present at follow -up （mean follow -up 8 weeks）. A modified one -layer VV was used in 17 men （ group 1 ） and a full - layer VV in 23 （ group 2）. Results sperm were present in both groups if surgery, was un- dertaken after vasal obstruction lasting 〈 36 months. The modified one - and two - layer VV had equal patency （88% and 91%, respectively） when undertaken after an obstructed interval of 36 -96 months; outcomes were poorer if surgery was performed after 〉96 months. The mean operative duration was 96 min for one - layer VV and 181 min for the full - layer VV. Conclusions A modified one - layer VV is simpler and faster in most cases. For most patients, both procedures have equivalent patency. A modified one - layer VV can be used as the preferred treatment.