改良微点双层显微输精管吻合术在腹股沟疝术后输精管梗阻患者治疗中的应用效果分析  

Outcomes of a modified microdot two-layer microsurgical vasovasostomy in the treatment of vas deferens obstruction caused by inguinal herniorrhaphy

作　　者：吕坤龙 张天标[1] 郑涛[1] 南永浩 王瑞[1] LYU Kunlong;ZHANG Tianbiao;ZHENG Tao;NAN Yonghao;WANG Rui(Department of Andrology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院男科,河南郑州450000

出　　处：《现代泌尿外科杂志》2023年第7期562-565,共4页Journal of Modern Urology

基　　金：河南省医学科技攻关计划项目(No.2018020144)。

摘　　要：目的介绍一种新的改良微点双层显微输精管吻合术(MVV),并分析其在腹股沟疝术后输精管梗阻患者中的应用效果。方法回顾性分析郑州大学第一附属医院男科2015年3月-2020年10月因腹股沟疝术后输精管梗阻行输精管吻合术的患者资料,按手术方式不同分为改良微点双层MVV组和传统微点双层MVV组。对两组患者的基本资料、术中情况、术后效果、并发症发生情况进行比较。结果改良组共59例,成功随访54例(91.5%);传统组共41例,成功随访38例(92.7%)。两组患者年龄、腹股沟疝手术史、单双侧手术比例差异均无统计学意义(P>0.05)。改良组平均单侧手术时间少于传统组[(89.44±24.86)min vs.(112.04±43.40)min,P=0.032]。两组在术后复通率(83.3%vs.73.7%)、自然怀孕率(33.3%vs.28.9%)方面效果相当(P>0.05)。改良组、传统组分别出现2例(3.70%)、1例(2.63%)术后并发症,均为切口脂肪液化,差异无统计学意义(P>0.05)。结论改良微点双层MVV是一种安全的、与传统微点双层MVV效果相当的手术方法,其通过调整标记点的位置和缝合顺序,达到便于术中缝线管理、降低吻合难度、节省手术时间的效果,可以应用于腹股沟疝术后输精管梗阻的修复。Objective To introduce a modified microdot two-layer microsurgical vasovasostomy(MVV)and to analyze its effectiveness in patients with vas deferens obstruction caused by inguinal herniorrhaphy.Methods Clinical data of patients treated during Mar.2015 and Oct.2020 were retrospectively analyzed.According to different surgical methods,the patients were divided into the modified group and traditional group.The general data,intraoperative conditions,efficacies and complications of the two groups were compared.Results There were 59 cases in the modified group,54(91.5%)of whom were successfully followed up,and 41 cases in the traditional group,38(92.7%)of whom were successfully followed up.There were no significant differences in age,inguinal herniorrhaphy history,and unilateral/bilateral ratio between the two groups(P>0.05).The average operation time for unilateral lesions in the modified group was shorter than that in the traditional group[(89.44±24.86)vs.(112.04±43.40)min,P=0.032].The postoperative patency rate(83.3%vs.73.7%,P>0.05)and natural pregnancy rate(33.3%vs.28.9%,P>0.05)of the modified group and traditional group were comparable.Incision fat liquefaction occurred in 2 cases(3.70%)in the modified group and in 1 case(2.63%)in the traditional group(P>0.05).Conclusion The modified microdot two-layer MVV is a safe surgical method with comparable effectiveness as the traditional approach.By adjusting the position of the marking points and the order of suturing,it helps the management of sutures,reduces the difficulty of vasovasostomy,shortens operation time,and can be applied to repair vas deferens obstruction caused by inguinal herniorrhaphy.

关 键 词：输精管梗阻 输精管吻合术 显微手术 腹股沟疝 男性不育 

分 类 号：R699[医药卫生—泌尿科学]