摘要
目的探讨术前磁共振成像(MRI)分类指导精囊镜技术治疗精道远端疾病的可行性和安全性。方法回顾性分析2019年1月至2023年2月在合肥市第二人民医院接受精囊镜技术治疗的35例精道远端疾病患者的临床资料。所有患者术前均接受了精道远端的MRI检查,根据MRI影像学结果分为梗阻型精道远端疾病与非梗阻精道远端疾病两种类型。所有患者在硬膜外麻醉或全麻下接受F6/7.5精囊镜检查,分析并对比两种类型患者精囊镜手术的进镜成功率、进镜方式、手术时间、术后并发症等。结果35例精囊镜手术精囊镜均成功进入精囊。17例MRI诊断为梗阻型精道远端疾病的患者中,有88.2%(15/17)的患者术中需经小囊途径进入精囊,平均手术时间为(96.8±58.7)min;18例MRI诊断为非梗阻型精道远端疾病的患者中,有44.4%(8/18)的患者需经小囊途径进入精囊,平均手术时间为(96.9±59.2)min。两类患者进镜方式比较,差异具有统计学意义(P<0.05);但手术时间比较,差异无统计学意义(P>0.05)。经术后随访,所有患者均未出现附睾炎、逆行射精、直肠损伤等严重并发症。结论术前通过MRI影像对精道远端疾病患者进行分类可以有效指导精囊镜手术方式的选择,提高手术进镜的成功率,提高手术的安全性。
Objective To explore the feasibility and safety of preoperative magnetic resonance imaging(MRI)classification guiding seminal vesiculoscopy technique for treating distal seminal tract diseases.Methods The clinical data of 35 patients with distal seminal tract diseases who received seminal vesiculoscopy technique treatment at the Second People′s Hospital of Hefei from January 2019 to February 2023 were retrospective analyzed.All patients underwent preoperative MRI of the distal part of the seminal tract,and were classified into two types based on the MRI imaging results:obstructive distal seminal tract diseases and non-obstructive distal seminal tract diseases.All patients underwent F6/7.5 seminal vesiculoscopy under epidural anaesthesia or general anaesthesia,and the vesiculoscope entry success rate,entry mode,operation time and postoperative complications of seminal vesiculoscopy in the two groups were analyzed and compared.Results Successful vesiculoscope entry into the seminal vesicle was achieved in all 35 cases of seminal vesiculoscopy.Of the 17 patients diagnosed with obstructive distal seminal tract diseases by MRI,seminal vesicle entry via the small sac was required in 88.2%(15/17)patients,with an average operation time of(96.8±58.7)minutes.Meanwhile,of the 18 patients diagnosed as non-obstructive distal seminal tract diseases by MRI,and seminal vesicle entry via the small sac was required in 44.4%(8/18)patients,with an average operation time of(96.9±59.2)minutes.There was statistically significant difference between two group of patients in entry methods was(P<0.05),but not in operation times(P>0.05).Postoperative follow-up revealed no serious complications like epididymitis,retrograde ejaculation,or rectal injury in all patients.Conclusions Preoperative MRI classification effectively guides the choice of seminal vesiculoscopy approach in distal seminal tract disease patients,improves vesiculoscope entry success rate of surgery and increases safety of the surgery.
作者
倪大伟
宋涛
刘昆
吴畏
齐伟
张艳斌
NI Dawei;SONG Tao;LIU Kun;WU Wei;QI Wei;ZHANG Yanbin(Department of Urology,Hefei Hospital Affiliated to Anhui Medical University(the Second People′s Hospital of Hefei),Hefei 230011,Anhui,China;Department of Andrology,Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing 210008,Jiangsu,China)
出处
《中国性科学》
2024年第2期21-25,共5页
Chinese Journal of Human Sexuality
基金
安徽省重点研究与开发计划项目(2022e07020062)。
关键词
精囊镜
磁共振成像
射精管梗阻
精道远端疾病
Seminal vesiculoscopy
Magnetic resonance imaging
Ejaculatory duct obstruction
Distal seminal tract diseases
