Cikrit D F, Dalsing M C, Weinstein T S, Palmer K, Lalka S G, Unthank J L
Department of Surgery, Indiana University Medical Center, Indianapolis 46202.
Lasers Surg Med. 1990;10(6):584-90. doi: 10.1002/lsm.1900100611.
The milliwatt CO2 laser was used to perform end-to-end anastomoses in canine jugular veins. There was a high disruption rate (50%) in laser-welded veins (n = 10). Fibrin glue (n = 17), formed from human fresh-frozen plasma, enhanced the weld strength decreasing the disruption rate (18%), resulting in an 82% patency which nearly equaled the contralateral sutured vein patency (93%). The bursting strength was improved with fibrin glue. Transmural necrosis was present initially in all groups but extended for a longer distance in the vessel wall in laser-welded anastomoses. Sutured anastomoses exhibited a greater inflammatory response. In laser-welded anastomoses endothelial cells were not as confluent as in sutured anastomoses by six weeks. Carbon dioxide laser-welded end-to-end vein anastomoses appear to be impractical because they disrupt too easily. However, the addition of heterologous fibrin glue to the weld results in a reasonably strong anastomosis with histologic properties that may be beneficial in vein bypass grafts.
使用毫瓦级二氧化碳激光对犬颈静脉进行端端吻合。激光焊接的静脉（n = 10）中断率很高（50%）。由人新鲜冰冻血浆制成的纤维蛋白胶（n = 17）增强了焊接强度，降低了中断率（18%），通畅率达到82%，几乎与对侧缝合静脉的通畅率（93%）相当。纤维蛋白胶提高了破裂强度。所有组最初均出现透壁坏死，但在激光焊接吻合处的血管壁中坏死延伸的距离更长。缝合吻合表现出更强的炎症反应。到六周时，激光焊接吻合处的内皮细胞不如缝合吻合处的内皮细胞融合。二氧化碳激光焊接的端端静脉吻合似乎不切实际，因为它们太容易中断。然而，在焊接处添加异源纤维蛋白胶可形成相当牢固的吻合，其组织学特性可能对静脉搭桥移植有益。
