Stichhauer Radek, Koudelka Jaroslav, Ryska Ales, Zivna Helena, Kaska Milan
Department of Paediatric Surgery, University Hospital Hradec Kralove, Czech Republic.
Academic Department of Surgery, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019 Dec;163(4):335-340. doi: 10.5507/bp.2018.069. Epub 2018 Nov 15.
The aim of this study was to evaluate whether the different vasovasostomy techniques can be performed using only the operating loupe in a rat model. The secondary aims were to evaluate the patency rate and inflammation of the vas deferens (VD) after contusion and the different vasovasostomy repair techniques.
A total of 40 male rats were divided into 4 groups based on the type of surgery: 1. contusion of the VD; 2. cutting of the VD and vasovasostomy with absorbable sutures; 3. cutting and joining of the VD using absorbable sutures with an intraluminally situated lead fibre; and 4. cutting and joining of the VD using non-absorbable sutures with an intraluminally situated lead fibre. Ninety days after the surgery the VD was resected, patency and histopathological signs of inflammation in the VD were evaluated.
All vasovasostomy techniques were successfully performed in all animals using only the operating loupe. The patency rate was 100% in the subgroup with contusion. Differences in the patency rates were found among the subgroups with vasovasostomy (P=0.007). The patency rate was higher in the subgroup that underwent group 3. Compared with vasovasostomies, contusion was associated with lower rates of inflammation (P=0.02) and severe inflammation (P=0.003). No differences were found among the subgroups of vasovasostomy techniques.
Contusion of the VD was not related to impairment in terms of patency. Vasovasostomy with an intraluminally situated lead fibre resulted in the highest patency rate among the standard vasovasostomy techniques.
本研究旨在评估在大鼠模型中仅使用手术放大镜能否实施不同的输精管吻合技术。次要目的是评估输精管（VD）挫伤后以及不同输精管吻合修复技术的通畅率和炎症情况。
根据手术类型将40只雄性大鼠分为4组：1. VD挫伤组；2. VD切断并用可吸收缝线进行输精管吻合组；3. 使用带腔内铅纤维的可吸收缝线切断并连接VD组；4. 使用带腔内铅纤维的不可吸收缝线切断并连接VD组。手术后90天切除VD，评估VD的通畅情况和炎症的组织病理学征象。
仅使用手术放大镜，所有动物均成功实施了所有输精管吻合技术。挫伤亚组的通畅率为100%。输精管吻合亚组之间的通畅率存在差异（P = 0.007）。第3组亚组的通畅率更高。与输精管吻合相比，挫伤的炎症发生率较低（P = 0.02），严重炎症发生率较低（P = 0.003）。输精管吻合技术亚组之间未发现差异。
VD挫伤在通畅性方面与功能损害无关。在标准输精管吻合技术中，带腔内铅纤维的输精管吻合通畅率最高。
