Problems unique to microsurgical epididymovasostomy. Comparison of four techniques in a laboratory rat model with review of the literature.
The new microsurgical techniques, tubule and loop intussusception, are compared to end-to-end and side-to-end in an experimental rat model. Sixty adult male Sprague-Dawley rats were operated on bilaterally under the same conditions. The four microsurgical techniques differ in approach to the inner mucosal layer, while the outer adventitial layer was sutured similarly in all cases. Luminal patency was checked 3 months postoperatively. There was no statistically significant difference in the patency rate among these four techniques (P = 0.3196). However, the incidence of macroscopically (P < 0.001) and microscopically (P < 0.01) detected spermatic granulomas was highly significant despite the optimum size match for each method. We found side-to-end techniques superior and easier to perform than end-to-end. The loop intussusception offers the highest patency rate (100%) with the lowest incidence of spermatic granuloma (10%). It was, therefore, concluded that selection of surgical technique is of utmost importance for durability of anastomosis.
Stefanović
K B
KB
Microsurgical Replantation Transplantation Department, Davies Medical Center, San Francisco, California.
Buncke
H J
HJ
Clark
S A
SA
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D004822:Epididymis / Q000601:surgery*; D007248:Infertility, Male / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley; D014649:Vas Deferens / Q000601:surgery*