Learning curves of microdissection testicular sperm extraction for nonobstructive azoospermia
Learning curves of microdissection testicular sperm extraction for nonobstructive azoospermia
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DOI：
10.1016/j.fertnstert.2009.03.108
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发表时间：
2010-08-01
影响因子：
6.7
通讯作者：
Fujisawa, Masato
中科院分区：
文献类型：
--
作者：
Ishikawa, Tomomoto;Nose, Ryuichiro;Fujisawa, Masato
目的：在一些有经验的男性不育中心进行了显微分离睾丸精子提取(Micro-TESE)。微型TESE在非梗阻性无精子症(NOA)患者中的应用已被证明不仅是可行和安全的，而且是一种技术要求高的手术。为了评价微-TESE对NOA患者手术效果的改善，我们报道了NOA患者的微TESE的学习曲线。设计：回顾性临床分析。地点：男性不育中心。患者(S)：自2006年以来，对150例NOA患者进行了微-TESE。干预(S)：打开白膜后，在25倍视野下直接检查睾丸实质。主要观察指标(S)：前50例(A组)，中50例(B组)，并对最后50例患者(C组)进行检查。结果(S)：三组间临床因素无差异。B组和C组总手术时间明显短于A组(P<；0.05)。B组(44%)和C组(48%)的取精率明显高于A组(32%；P<；0.05)。结论：随着病例的增多，手术效果和取精率均有所提高。我们认为，这份报告显示了像Micro-TESE这样的显微手术的大量学习曲线。(Fertil Steril(R)2010；94：1008-11.(C)2010年由美国生殖医学学会公布。)
Objectives: Microdissection testicular sperm extraction (micro-TESE) has been performed at some experienced male infertility centers. Micro-TESE in patients with nonobstructive azoospermia (NOA) has been shown to be not only feasible and safe but also a technically demanding operation. To evaluate whether the improvement of surgical outcomes of micro-TESE, we hereby report the learning curves of micro-TESE for NOA patients.Design: Retrospective clinical analysis.Setting: Male infertility center.Patient(s): Since 2006, micro-TESE was performed in 150 patients with NOA by a single surgeon.Intervention(s): After the tunica albuginea was opened, direct examination of the testicular parenchyma was performed at x25 magnification.Main Outcome Measure(s): Sperm retrieval rate and clinical factors in the first 50 patients (group A), the middle 50 patients (group B), and the last 50 patients (group C) were examined.Result(s): There were no differences in clinical factors among the three groups. Total operation times were shorter in group B and C than in group A (P < 0.05). The sperm retrieval rate in group B (44%) and C (48%) was significantly higher than in group A (32%; P < 0.05).Conclusion(s): As cases increase, surgical outcomes and sperm retrieval rate have improved. We think that this report showed substantial learning curves for a microscopic surgery such as micro-TESE. (Fertil Steril (R) 2010; 94: 1008-11. (C) 2010 by American Society for Reproductive Medicine.)