Department of Urology, Huangpu Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, China.
Asian J Androl. 2013 Jan;15(1):79-82. doi: 10.1038/aja.2012.100. Epub 2012 Oct 8.
This study is to evaluate the effectiveness of a modified single-armed suture technique for microsurgical vasoepididymostomy (VE) in patients with epididymal obstructive azoospermia. From September 2011 to December 2011, microsurgical two-suture longitudinal intussusception VEs were performed using our modified single-armed suture technique in 17 men with epididymal obstructive azoospermia at our hospital. Two of these patients underwent repeated VEs after previous failed VEs, and one patient underwent unilateral VE because of an occlusion of the left abdominal vas deferens. The presence of sperm in the semen sample at 3 months postoperation was used as the preliminary endpoint of this study. Each patient provided at least one semen sample at the 3-month time point, and the patency was assessed by the reappearance of sperm (>10(4) ml(-1)) in the semen. The mean operative time for the modified technique was 219 min. Patency was noted in 10 men (58.8%), including one patient who underwent repeated VE. The patient who underwent unilateral anastomosis manifested no sperm postoperatively in his semen. Sperm granulomas were not detected in this cohort. The results of this study demonstrate that our modified technique for microsurgical longitudinal intussusception VE is effective. We believe that it is a practical alternative that may reduce operation time and obviate the suture crossing.
本研究旨在评估改良单臂缝合技术在显微外科输精管附睾吻合术（VE）治疗附睾梗阻性无精子症患者中的有效性。2011 年 9 月至 12 月，我们采用改良单臂缝合技术对 17 例附睾梗阻性无精子症患者实施了显微外科双缝线纵向套入式 VE，其中 2 例患者曾因先前 VE 失败而接受重复 VE，1 例患者因左侧腹输精管阻塞而接受单侧 VE。术后 3 个月精液中出现精子作为本研究的初步终点。每位患者均在 3 个月时至少提供了一份精液样本，通过精液中精子（>10（4）ml（-1））的再次出现来评估吻合口通畅情况。改良技术的平均手术时间为 219 分钟。10 名男性（58.8%）吻合口通畅，其中 1 名患者接受了重复 VE。接受单侧吻合术的患者术后精液中无精子。本队列中未发现精子肉芽肿。本研究结果表明，我们改良的显微外科纵向套入式 VE 技术是有效的。我们认为，这是一种实用的替代方法，可缩短手术时间并避免缝线交叉。
