Wagenknecht L V, Klosterhalfen H, Schirren C
J Microsurg. 1980 Mar-Apr;1(5):370-6. doi: 10.1002/micr.1920010507.
Of 30,000 men examined for impaired fertility from 1964 to the present, 900 were diagnosed as having excretory azoospermia. Of this number, 465 underwent surgery. Epididymovasostomy was performed on 316 men. For 11 years, this surgery was done with surgical loupes, and a patency rate of 48% was achieved in those men undergoing bilateral epididymovasostomy. (Only 52% of our patients showed inflammatory obstruction.) In a small series of patients undergoing the procedure under the operating microscope, a patency rate of 75% was achieved. Vasovasostomy was performed in 20 patients with loupes and splints. Patency was obtained in 11 of the 17 that were followed. Ten of 12 patients receiving anastomosis by a technique placing nonabsorbable sutures through the entire wall of the vas became fertile. Nine of 10 patients who were operated on by a double-layer technique under the operating microscope were found to have patent ducts at follow-up. The advances in microsurgical techniques, equipment, and suture materials have considerably improved the changes for refertilization.
在1964年至目前接受不育症检查的30000名男性中，有900人被诊断为排泄性无精子症。其中，465人接受了手术。316名男性接受了附睾输精管吻合术。在11年的时间里，该手术是在手术放大镜下进行的，接受双侧附睾输精管吻合术的男性通畅率为48%。（我们的患者中只有52%表现为炎性梗阻。）在一小部分在手术显微镜下进行该手术的患者中，通畅率达到了75%。20名患者在手术放大镜和夹板辅助下进行了输精管吻合术。在接受随访的17名患者中，有11名实现了通畅。12名通过在输精管全壁放置不可吸收缝线的技术接受吻合术的患者中有10名恢复了生育能力。在手术显微镜下采用双层技术进行手术的10名患者中，有9名在随访时发现输精管通畅。显微外科技术、设备和缝合材料的进步显著提高了恢复生育能力的几率。
