PDF(Pubmed)
Abstract：
BACKGROUND: This study aimed to compare the outcomes of double-armed two-suture longitudinal intussusception microsurgical vasoepididymostomy (LIVE) and single-armed two-suture LIVE techniques in patients with epididymal obstructive azoospermia (EOA). The main outcomes assessed were patency rates, patency time, semen quality and natural pregnancy rates.
METHODS: Data from patients with EOA who underwent two-suture LIVE were obtained from databases including PubMed, EMBASE, and Web of Science. Weighted data were analyzed using a random-effects model, and weighted mean differences were reported.
RESULTS: A total of 1574 patients with EOA from 24 studies were included. The overall patency rate was approximately 68% (95% confidence interval [CI]: 63-72%), with a patency time of approximately 4.63 months (95% CI: 4.15-5.12). The sperm concentration reached 26.90 million/ml and the sperm motility was 23.74%. The natural pregnancy rate was 38% (95% CI: 31-46%). The different definitions of patency do not seem to have any meaningful impact when comparing patency rates. There was no significant difference in patency rates, patency time, semen quality and natural pregnancy rates between the double-armed and single-armed LIVE techniques.
CONCLUSIONS: The single-armed LIVE is a potential alternative surgical option when high quality double-needle sutures are not easily accessible.
METHODS: Data from patients with EOA who underwent two-suture LIVE were obtained from databases including PubMed, EMBASE, and Web of Science. Weighted data were analyzed using a random-effects model, and weighted mean differences were reported.
RESULTS: A total of 1574 patients with EOA from 24 studies were included. The overall patency rate was approximately 68% (95% confidence interval [CI]: 63-72%), with a patency time of approximately 4.63 months (95% CI: 4.15-5.12). The sperm concentration reached 26.90 million/ml and the sperm motility was 23.74%. The natural pregnancy rate was 38% (95% CI: 31-46%). The different definitions of patency do not seem to have any meaningful impact when comparing patency rates. There was no significant difference in patency rates, patency time, semen quality and natural pregnancy rates between the double-armed and single-armed LIVE techniques.
CONCLUSIONS: The single-armed LIVE is a potential alternative surgical option when high quality double-needle sutures are not easily accessible.
摘要：
背景：本研究旨在比较双臂双缝合纵向肠套叠显微外科血管附睾造口术（LIVE）和单臂双缝合LIVE技术在附睾梗阻性无精子症（EOA）患者中的疗效。评估的主要结果是通畅率，通畅时间，精液质量和自然妊娠率。
方法：从包括PubMed、EMBASE,和WebofScience。加权数据使用随机效应模型进行分析，并报告了加权平均差异。
结果：共纳入来自24项研究的1574例EOA患者。总体通畅率约为68％（95％置信区间[CI]：63-72％），通畅时间约为4.63个月（95%CI：4.15-5.12）。精子浓度达到2690万/ml，精子活力为23.74％。自然妊娠率为38%(95%CI:31-46%)。比较通畅率时，通畅性的不同定义似乎没有任何有意义的影响。通畅率没有显着差异，通畅时间，双臂和单臂活体技术之间的精液质量和自然妊娠率。
结论：当不容易获得高质量的双针缝线时，单臂LIVE是一种潜在的替代手术选择。
方法：从包括PubMed、EMBASE,和WebofScience。加权数据使用随机效应模型进行分析，并报告了加权平均差异。
结果：共纳入来自24项研究的1574例EOA患者。总体通畅率约为68％（95％置信区间[CI]：63-72％），通畅时间约为4.63个月（95%CI：4.15-5.12）。精子浓度达到2690万/ml，精子活力为23.74％。自然妊娠率为38%(95%CI:31-46%)。比较通畅率时，通畅性的不同定义似乎没有任何有意义的影响。通畅率没有显着差异，通畅时间，双臂和单臂活体技术之间的精液质量和自然妊娠率。
结论：当不容易获得高质量的双针缝线时，单臂LIVE是一种潜在的替代手术选择。
