Demiralp C O, Serel S, Zeyrek T, Demirseren M E, Ergun H, Yormuk E
Ankara Atatürk Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Turkey.
Bratisl Lek Listy. 2011;112(9):483-7.
The aim of this study was to develop an effective arterial anastomosis model with a high patency rate and low operation time. We introduced a new end-to-end microvascular anastomosis with geometrically adaptable ends.
In this technique, two triangular flaps were prepared at the end of the vessels and four stitches applied on the tip of those flaps. During this study, 15 new technique anastomoses were compared to 15 conventional 8 stitches anastomoses in 30 rat femoral arteries. Operating time, patency rates and number of stitches with consequential effects on the vessel wall were analyzed statistically. The anastomotic patency of both groups was assessed by: (1) in vivo observation using the milking test under the operating microscope and (2) flow study using laser Doppler ultrasound. Healing was assessed by the light and electron microscopy.
According to statistical results and compared to the conventional method, the new technique was associated with a significant time savings (mean 18 vs 26 minutes, p < 0.001). The patency rates were equivalent to the conventional technique by observation and laser Doppler ultrasound (p > 0.05). Histological evaluation of both techniques showed that rats operated with the new technique healed faster and with less endothelial damage.
This new "Geometrically Adaptable Ends Technique" is faster, easier to perform and a reliable method with patency and flow characteristics similar to those of the conventional end-to-end anastomoses (Fig. 7, Ref. 20).
本研究旨在开发一种具有高通畅率和低手术时间的有效动脉吻合模型。我们引入了一种具有几何形状适应性末端的新型端对端微血管吻合术。
在该技术中，在血管末端制备两个三角形皮瓣，并在这些皮瓣的尖端应用四针缝合。在本研究中，对30只大鼠股动脉中的15个新技术吻合口与15个传统的8针吻合口进行了比较。对手术时间、通畅率以及对血管壁有相应影响的缝合针数进行了统计学分析。两组的吻合通畅性通过以下方式评估：（1）在手术显微镜下使用挤奶试验进行体内观察，以及（2）使用激光多普勒超声进行血流研究。通过光学显微镜和电子显微镜评估愈合情况。
根据统计结果，与传统方法相比，新技术显著节省了时间（平均18分钟对26分钟，p<0.001）。通过观察和激光多普勒超声，通畅率与传统技术相当（p>0.05）。两种技术的组织学评估表明，采用新技术手术的大鼠愈合更快，内皮损伤更小。
这种新的“几何形状适应性末端技术”更快、更易于操作，是一种可靠的方法，其通畅性和血流特性与传统的端对端吻合术相似（图7，参考文献20）。
