改良双针缝线显微输精管附睾吻合术与疗效评价

Modified double-armed suture technique for microsurgical vasoepididymostomy and its clinical efficacy

目的探讨应用改良双针缝线显微输精管附睾吻合技术治疗附睾梗阻性无精子症的临床疗效。方法回顾性分析2013年11月至2017年11月期间河南省人民医院应用改良双针缝线显微输精管附睾吻合技术治疗附睾梗阻性无精子症患者118例的临床资料,分析其围手术期情况、术后复通情况和配偶妊娠情况。结果手术时间为(217±56)min,研究期内未见切口感染、精液瘘、精液囊肿等并发症。术后3、6、9、12、18个月行精液常规检查,术后18个月时精子浓度为(25.1±11.5)×10^6/mL、前向运动精子百分率为(38.2±16.4)%,手术临床复通率为70.9%(73/103),患者配偶自然妊娠率为38.8%(40/103),10例患者夫妇经自然妊娠出生健康婴儿。结论改良双针缝线显微输精管附睾吻合术临床疗效良好,是无双针缝线时的合适选择。

Objective To explore the clinical efficacy of modified double-armed suture technique for microsurgical vasoepididymostomy in patients with epididymal obstructive azoospermia(EOA).Methods The retrospective study included 118 cases with EOA who underwent microsurgical vasoepididymostomy by using modified double-armed suture technique from November 2013 to November 2017,the perioperative complication,the patency rate and the pregnancy rate were analyzed.Results The operating time was(217±56)min.No severe adverse events or complications like spermatocele were observed.Semen analyses were preformed 3 months,6 months,9 months,12 months and 18 months after operation.The density of sperm was(25.1±11.5)×10^6/mL on 18 months after operation,the sperm motility was(38.2±16.4)%,the patency rate was 70.9%(73/103),the pregnancy rate was 38.8%(40/103).Ten couples had healthy babies birth by natural pregnancy.Conclusion Modified double-armed suture technique is an efficacy and safety technique in treating EOA.It's a practical alternative in the areas without the specialized double-armed sutures.