一种有效的纵向套叠显微输精管附睾吻合术

An effective longitudinal intussusception microsurgical vasoepididymostomy

目的总结自行改良的纵向套叠显微输精管附睾吻合术的操作经验,以提高术后复通率。方法 2012年2月至2013年11月,应用改良的单针缝线技术为51例附睾梗阻性无精症患者实施纵向套叠显微输精管附睾吻合术。术后每3个月进行一次精液分析,精子密度>104/ml定义为复通。1年随访期结束或复通设定为研究终点。结果平均手术时间为(216±51)min。随访39例,24例(61.5%)复通。仅1例(1.9%)术后出现阴囊血肿及尿道狭窄。结论改良的显微输精管附睾吻合术安全有效,精良的显微外科技术是术后复通的必要条件。

Objective To summarize the manipulative experience in the modified technique for longitudinal intussusception microsurgical vasoepididymostomy and increase the postoperative patency rate. Methods From February 2012 to November 2013, we performed longitudinal intussusception microsurgical vasoepididymostomies using our modified technique in 51 patients with epididymal obstructive azoospermia. Semen was analyzed at 3-month intervals and patency was assessed by return of the sperm （〉104/ml） in the semen. The end of one-year follow up or presence of sperm in the semen postoperatively was designed as the endpoint of this study. Results The mean operative time was （216_＋51） minutes. 39 patients were followed up and 24 （61.5%） of them showed patency. One patient suffered from scrotal hematoma and urethral stricture. Conclusions The modified technique for microsurgical vasoepididymostomy is safe and effective. The refinement of microsurgical technique is prerequisite for postoperative patency.