PubMed Health⌕ Search

Biomedical subjects

O Vankemmel

Publications and source records attributed to O Vankemmel.

7 recordsLinked to original sources

Evaluation of a fibrin sealant free of bovine-derived components in an experimental vas anastomosis study.

OBJECTIVES: The risk of transmission of bovine spongiform encephalopathy cannot be excluded from the use of bovine-derived products. The present study was undertaken to evaluate the performance of a new fibrin glue free of bovine-derived components in vas anastomosis and to compare this product to conventional vas anastomosis with fibrin glue. METHODS: Bilateral delayed vas anastomosis was performed in 40 Sprague-Dawley rats. All animals underwent a fibrin glue-assisted vas anastomosis with three transmural sutures tied prior to fibrin glue application. The composition and preparation of fibrin glue was similar for all vas anastomoses except the fibrinolysis inhibitor component which was aprotinin (3,000 KUI/ml) in group 1 and tranexamic acid (10 mg/ml) in group 2. The animals (20 rats in both groups) were sacrificed 7 weeks postoperatively and evaluated for gross patency, presence of sperm granuloma and tensile strength measurements at the anastomosis site. RESULTS: No difference was found between the 2 groups for all parameters evaluated whether a bovine-derived or a synthetic fibrinolysis inhibitor component was used. CONCLUSION: This study showed that tranexamic acid, a fibrinolysis inhibitor, can be substituted for conventional fibrin glue thereby avoiding the risks of bovine products.

Anastomosis, Surgical↗

Correlation between genito-urinary anomalies, semen analysis and CFTR genotype in patients with congenital bilateral absence of the vas deferens.

OBJECTIVE: To evaluate the incidence of renal and seminal vesicle (SV) abnormalities, and the presence or absence of CFTR gene mutations, in a cohort of patients referred for congenital bilateral absence of the vas deferens (CBAVD). PATIENTS AND METHOD: Forty-one patients with CBAVD, confirmed by surgical exploration, were evaluated by ultrasonography for renal and SV anomalies. Semen variables (pH, fructose level and ejaculate volume), sweat chloride levels and mutations of the 3, 4, 7, 9, 10, 11, 13, 14b, 17b, 19, 20 and 21 exons of the CFTR gene were determined. RESULT: In eight patients with renal anomalies there were no detectable mutations of CFTR, compared with 23 in the 33 patients with no renal anomalies (P < 0.02). SV anomalies were not related to the presence or absence of mutations (11 of 23 vs 11 of 18), or in compound heterozygote patients carrying two mutations (eight of 13 vs three of 10). Semen variables (pH < 7.2, fructose < 1 g/L and ejaculate volume < 2 mL) did not differentiate patients with or without anomalies of the kidney, SV or with mutations, except in patients with a pH < 7.2 for which renal anomalies were less frequent (two of 25 vs six of 16, P < 0.05) and mutations more frequent (19 of 25 vs five of 12, P < 0.01). CONCLUSION: Renal anomalies associated with CBAVD should be considered as supporting maldevelopment as a cause, but analysis of CFTR mutations in these cases should not be omitted. Unlike anomalies of the SV, a low ejaculate volume or low fructose level, a semen pH of < 7.2 is the only nonspecific variable in patients with CFTR mutations.

Adolescent↗

Vasal reanastomosis using fibrin glue combined with sutures: which combination of sutures in a delayed protocol? Experimental study in rats.

OBJECTIVES: The actual number of transmural sutures needed to ensure a successful fibrin-glued vasovasostomy is a key study parameter of the few experimental works already published. The present work was done to evaluate fibrin-glued vasovasostomy in rats in combination with only 2 transmural sutures. We compared the results to our previous study in which we demonstrated the efficiency of a combination of the use of fibrin glue with 3 sutures in comparison with a conventional microsurgical technique. MATERIALS AND METHODS: Twenty Sprague-Dawley rats underwent bilateral vasectomy followed 2 weeks later by bilateral vasovasostomy using fibrin glue combined with 2 transmural sutures. Each animal was sacrificed 7 weeks postoperatively after a 3-week mating period with a Sprague-Dawley female rat, the vasal specimens were evaluated for sperm granuloma formation. Mean operative time and fertility rates were recorded. RESULTS: The combination of fibrin glue with 2 transmural sutures gave evidence of less successful performances than the combination with 3 transmural sutures and the conventional microsurgical technique for all parameters evaluated but the mean operative time. CONCLUSION: Our study underlines the need for a third transmural suture placed 120 degrees apart from the others when performing a fibrin glue delayed vasovasostomy. This allows a better vas lumen opening at the anastomotic site and therefore a more efficient vasal anastomosis in a delayed protocol.

Anastomosis, Surgical↗

Delayed vasovasostomy: experimental study using fibrin glue.

We compare delayed vasectomy reversals performed in rats using fibrin glue combined with 3 transmural sutures or a conventional microsurgical technique. Forty Sprague-Dawley rats underwent bilateral vasectomy followed 2 weeks later by bilateral vasovasostomy using fibrin glue or a conventional microsurgical suture technique. Our protocol evaluated fertility rates after a 3-week mating period, sperm granuloma formation, histological changes at the anastomotic site, longitudinal tensile strength and mean testicular weight. The fibrin glue technique required significantly reduced operative time (p < 0.0005) and showed statistically lower tensile strength performance (p < 0.0005). All other parameters showed no statistical difference between the two techniques. Fibrin-glued vasovasostomy is efficient in a delayed protocol and deserves further clinical experience.

Animals↗

Delayed vasal reanastomosis in rats: comparison of a microsurgical technique and a fibrin-glued procedure.

OBJECTIVES: To compare fibrin-glued vasovasostomy to a conventional microsurgical technique in a protocol of delayed vasovasostomy. MATERIALS AND METHODS: Forty male Sprague-Dawley rats underwent bilateral vasectomy through a midline abdominal incision. Two weeks later all animals underwent a bilateral vasectomy reversal through a bilateral inguino-scrotal incision, following two different protocols. Invariably, the proximal segment had a larger lumen. The control group (20 rats) had a conventional modified one-layer sutured vasal anastomosis with 10/0 nylon. The experimental group (20 rats) underwent vasal anastomosis using fibrin glue and consisting of three transmural sutures with 10/0 nylon followed by the application of fibrin glue circumferentially to seal the anastomosis. The fibrin-tissue adhesive was obtained from pooled donor plasma and was virally inactivated by a solvent-detergent treatment. Seven weeks after surgery all animals were killed and the vasal specimens were evaluated for gross patency and the incidence of sperm granuloma. RESULTS: The control group had a patency rate of 85% and half had sperm granuloma. The experimental group had a patency rate of 92% and 40% had sperm granuloma; neither difference was significant. The mean operative time was significantly shorter for the fibrin glue-assisted vasovasostomy (P < 0.001). CONCLUSION: This study showed that a delayed fibrin-glued vasovasostomy gave a comparable anatomical success and an incidence of sperm granuloma similar to that using a conventional microsurgical technique, but with the advantages of a shorter operative time and a less technically demanding anastomosis.

Anastomosis, Surgical↗