Borovikov A M, Gilis J
Microsurgery Department, Medical Academy, Moscow, USSR.
Int Urol Nephrol. 1989;21(5):521-31. doi: 10.1007/BF02549591.
Based on the experience of 75 microsurgical reconstructions of the obstructed epididymis, the authors conclude that a simple introduction of microsurgery does not improve the results significantly. This experience, however, has provided a better understanding of the most important problems of epididymal surgery and has shown the ways to solve them. The principal means, they believe, is a well organized clinical study. Experimental data are hardly applicable to human sperm viae pathology. This clinical study should satisfy two requirements: a uniform operative technique and special account for an anastomosis level. End-to-side vasoepididymostomy is suggested to be the method of choice. A training model for epididymal microsurgery is elaborated and used for working out the above-mentioned technique. The reliability of the technique is shown in 20 rabbits, with litters from 17 couples. A special investigation of the microsurgically significant details of epididymal anatomy substantiates several separate zones marking out.
基于75例梗阻性附睾显微外科重建的经验，作者得出结论，单纯引入显微外科手术并不能显著改善手术效果。然而，这一经验使人们对附睾手术中最重要的问题有了更好的理解，并展示了解决这些问题的方法。他们认为，主要手段是进行精心组织的临床研究。实验数据几乎不适用于人类精子通道病理学。这项临床研究应满足两个要求：统一的手术技术和对吻合水平的特殊考量。建议采用端侧输精管附睾吻合术作为首选方法。精心制作了附睾显微外科手术训练模型，并用于完善上述技术。在20只兔子身上展示了该技术的可靠性，有17对兔子产仔。对附睾解剖结构中具有显微外科意义的细节进行的专项研究证实了几个不同区域的划分。
