Saunders Marnie M, Baxter Z Chad, Abou-Elella Ashraf, Kunselman Allen R, Trussell J C
Center for Biomedical Engineering, University of Kentucky, Wenner-Gren Research Laboratory, Lexington, Kentucky, USA.
Fertil Steril. 2009 Feb;91(2):560-5. doi: 10.1016/j.fertnstert.2007.12.006. Epub 2008 Mar 4.
To compare operative time, patency, and integrity of glue-assisted versus suture-only vasovasostomies.
A Medline search revealed no vasovasostomy studies testing tissue adhesives other than fibrin. We compare glue-reinforced to suture-only vasovasostomies.
An academic medical center.
PATIENT(S): None.
INTERVENTION(S): Using bull vas deferens, we performed: [1] two-layer anastomoses, [2] modified one-layer anatomoses, and [3] Bioglue, Dermabond, or CoSeal-reinforced anastomoses supported by three transmural sutures.
MAIN OUTCOME MEASURE(S): Operative times were recorded, patency verified, and microscopic dissection performed to rule out luminal glue intravasation. Destructive mechanical testing was then completed with statistical comparison of load to failure, displacement to failure, and linear stiffness.
RESULT(S): Operative time was greatest for two-layer anastomoses and significantly reduced for all three glue-reinforced three-suture anastomoses. All techniques were patent and free of glue intravasation. BioGlue and Dermabond demonstrated greater integrity than all other techniques. Mechanically, BioGlue and Dermabond were superior to both the unreinforced three stitch and CoSeal groups and were capable of resisting higher loads before failure.
CONCLUSION(S): Glue-reinforced anastomoses are significantly less time consuming than traditional techniques. BioGlue and Dermabond have greater mechanical integrity and may be superior to both CoSeal and the sutured techniques.
比较胶水辅助输精管吻合术与单纯缝合输精管吻合术的手术时间、通畅率和完整性。
一项医学文献检索显示，除纤维蛋白外，尚无关于测试组织粘合剂的输精管吻合术研究。我们比较了胶水增强型与单纯缝合型输精管吻合术。
一家学术医疗中心。
无。
使用公牛输精管，我们进行了：[1] 双层吻合术，[2] 改良单层吻合术，以及 [3] 由三根贯穿缝合线支持的生物胶、皮肤粘合剂或CoSeal增强吻合术。
记录手术时间，验证通畅率，并进行显微镜解剖以排除管腔内胶水渗入。然后完成破坏性机械测试，并对破坏载荷、破坏位移和线性刚度进行统计学比较。
双层吻合术的手术时间最长，而所有三种胶水增强型三针吻合术的手术时间均显著缩短。所有技术均保持通畅且无胶水渗入。生物胶和皮肤粘合剂的完整性优于所有其他技术。在力学方面，生物胶和皮肤粘合剂优于未增强的三针组和CoSeal组，并且在破坏前能够承受更高的载荷。
胶水增强型吻合术比传统技术显著节省时间。生物胶和皮肤粘合剂具有更高的机械完整性，可能优于CoSeal和缝合技术。
