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Fırat Tıp Dergisi
2002, Cilt 7, Sayı 4, Sayfa(lar) 875-877
[ Turkish ]
Conventional Microsurgical Vasovasostomy Vs Z-plasty Vasovasostomy
Ahmet KAZEZ1, İbrahim H. ÖZERCAN2, M. Ergun PARMAKSIZ1
1Fırat Üniversitesi Tıp Fakültesi Çocuk Cerrahisi AD, ELAZIĞ
2Fırat Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı, ELAZIĞ

Objective: Microsurgically end-to-end anastomosis with interrupted sutures is gold standard for vasovasostomy. Stenosis or infertility may develop after this procedure. It has been reported that Z-plasty provides a better anastomotic patency rate in microvasculer anastomosis. An experimental study was designed to compare conventional microsurgery with Z-plasty anastomosis on vasovasostomy.

Material and Methods: A total of 21 male Wistar-albino rats were divided into three groups (control, conventional microsurgical vasovasostomy, Z-plasty microsurgical vasovasostomy) each containing 7 rats. Anastomoses were carried out under an operating microscope with interrupted, single layer 10/0 Ethilon® sutures. After six weeks, their fertility rates, anastomotic patency rate and pathological changes in the area of anastomosis were assessed. The results were compared statistically.

Results: The control group had a fertility rate of 70%, and fertility rates were 56% and 50% in the groups II and III, respectively. Anastomoses were obliterated in one (15%) in each test groups. Fertility rates and patency rate were not statistically significant in test groups. Inflammation seen around the anastomosis area in the Z-plasty group was more prominent than standard vasovasostomy applied-rats.

Conclusions: It has been determined that application of Z-plasty to the standard anastomosis for vasovasostomy brings about an additional technical difficulty but does not provide any advantage as in vascular structures. The reasons for the failure of Z-plasty technique could be anatomical differences between ductus defference and vasculer sutructures. As a result, standard microsurgical vasovasostomy still seems to be the most valid method for vasovasostomy.

[ Turkish ]
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