Gilis J, Borovikov A M
Department of Microsurgery, Medical Academy, Moscow, USSR.
Int Urol Nephrol. 1989;21(6):627-34. doi: 10.1007/BF02559620.
Based on the experience of 12 vas deferens reconstructions in 8 patients with iatrogenic (post-herniotomy in infancy) vasa lesions the authors conclude that in the majority of such cases the length of vas defects renders direct vasovasoanastomosis either impossible or too risky, due to tension. To solve the problem the methods of extraanatomical (sub- and suprapubic) vas rerouting were elaborated that allow to shorten the vas length necessary for anastomosing by 9-14 cm. Combined with various crossover techniques, and vasoepididymostomy if necessary, the method proved valuable in most cases of extensive mono- and bilateral vasa deferentia lesions. The experimental data on vas segment transplantation obtained in rats show poor results in the homotransplantation group while autotransplants survive in 70% and provide vas patency restoration in 40%. No experimental proof in favour of endoprosthesing of vas grafts is obtained.
基于对8例医源性（婴儿期疝修补术后）输精管病变患者进行12次输精管重建的经验，作者得出结论：在大多数此类病例中，由于张力，输精管缺损的长度使得直接输精管吻合术要么无法进行，要么风险太大。为了解决这个问题，精心设计了解剖外（耻骨下和耻骨上）输精管改道方法，这些方法可使吻合所需的输精管长度缩短9至14厘米。结合各种交叉技术，并在必要时进行输精管附睾吻合术，该方法在大多数广泛性单侧和双侧输精管病变病例中被证明是有价值的。在大鼠身上获得的输精管段移植实验数据显示，同种移植组效果不佳，而自体移植的存活率为70%，输精管通畅恢复率为40%。未获得支持输精管移植物内置假体的实验证据。
