摘要
目的探讨显微输精管交叉吻合术治疗复杂性梗阻性无精子症的临床疗效和安全性。方法 2012年11月-2014年12月通过显微输精管交叉吻合术治疗9例复杂性梗阻性无精子症。6例一侧由于疝手术损伤造成输精管缺损无法吻合,另一侧输精管近端通畅但附睾梗阻;3例一侧输精管进腹腔段梗阻,无法吻合,另一侧附睾梗阻,均进行显微输精管交叉吻合术：将一侧近端输精管通过阴囊中隔穿至另一侧阴囊,与另一侧远端输精管进行双层显微吻合。结果 9例均复通成功,复通率100%。1例在术后5个月再次梗阻。9例术后随访3-26个月,平均13个月,5例配偶自然受孕,术后均无不适和其他并发症发生。结论显微输精管交叉吻合术治疗复杂性输精管梗阻安全、有效,使既往只能通过睾丸穿刺进行辅助生殖的患者有自然生育的机会。
Objective To evaluate the efficacy and safety of microsurgical crossed vasovasostomy for complicated obstructive azoospermia（ OA）. Methods A total of 9 patients with complicated OA underwent microsurgical crossed vasovasostomy from November 2012 to December 2014. Six patients had previous bilateral hernia repairs. We found that a large section of seminiferous duct was cut off due to hernia surgery and there was an epididymal obstruction on the other side. For other 3 patients,we found obstruction of intracorporeal seminiferous duct on one side and epididymal obstruction on the other side. We put the proximal seminiferous duct crossing the scrotal septum to the other side, and then performed microsurgical vasovasostomy. Two layers anastomosis was utilized. Results The crossed vasovasostomy was successfully performed in all the 9 cases,achieving a patency rate of 100%. Recurrent obstruction occurred at five postoperative month in 1 case. Follow-up examinations were carried out for a mean of13 months（ range,3- 26 months）. The pregnancy rate was 62. 5%（ 5 /8）. Nobody complained uncomfortable. Conclusions Microsurgical crossed vasovasostomy is effective and safe for patients with complicated OA. It helps patients with complicated OA to have their children naturally.
出处
《中国微创外科杂志》
CSCD
北大核心
2015年第3期228-231,共4页
Chinese Journal of Minimally Invasive Surgery
基金
北京大学第三医院院内重点项目资助
