横向双针套叠显微输精管附睾管吻合术治疗梗阻性无精症

目的观察横向双针套叠显微输精管附睾管吻合术治疗梗阻性无精症的临床效果。方法我科自2007年5月至2007年12月选择6例确诊为梗阻性无精子症并证实为附睾水平梗阻的患者行横向双针套叠附睾管输精管吻合，即以10-0双针尼龙线在附睾管上横向缝合两针，将针以内进外出方式穿过输精管壁，然后在两针之间以显微刀横向切开附睾管，证实有精子后打结，8-0尼龙线缝合附睾浆膜和输精管肌层，术后随访6．13个月。结果4例术后精液分析可见精子，其中1例精液分析结果正常者生育一女；1例表现为少精症；2例表现为弱精症。手术成功率66．7％（4／6）。结论横向双针套叠显微输精管附睾管吻合术操作相对简单，疗效满意，不失为一种值得推广的阻性无精症治疗技术。

2-suture transversal intussusception vasoepididymostomy : an effective procedure

Obits＇five Vasoepididymostomy remains one of the most technically challenging procedures in all of microsurgery. It is said that 2-suture intussusception is the most superior techniques in treating obstructive azoospermia. We report our 2- suture transversal intussusception vasoepididymostomy. Methods We recorded the results of 6 consecutive vasoepdidymostomies from may 2007 to december 2007. Two parallel sutures were placed in the selected epididymal tubule, oriented transversal, then the tubule was incised between the two needles. Once the epididymal tubule has been incised, the sutures were pulled through.Data collected included months of follow-up, sperm density, motility. Results Motile sperm were found in the ejacalates of 4 of 6 （66.7%）. Conclusions Transversal two-suture intussusception vasoepididymostomy method simplifies the performance of the anastomosis, it is still the preferred and effective method in the treatment of obstructive azoospermia.