Liu Shi-qi, Lei Peng, Cao Zhu-ping, Lv Yi, Li Jian-hui, Cui Xiao-hai
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China.
Ann Vasc Surg. 2012 Oct;26(7):985-95. doi: 10.1016/j.avsg.2012.04.003. Epub 2012 Jul 25.
The goal of this study was to evaluate the performance of the magnetic pinned-ring device for nonsuture vascular anastomosis.
The magnetic pinned-ring device consists of paired magnetic rings that are coated with titanium nitride and embedded in a polypropylene shell; the rings are equipped with alternately spaced holes and titanium pins. The vascular anastomosis procedure using the novel magnetic pinned-ring device was performed on 14 mongrel dogs, and the traditional hand-sewing technique was used on 14 additional dogs. In situ end-to-end anastomoses were performed in the femoral artery and the inferior vena cava. Patency was confirmed through ultrasonographic scans at different time points as late as 24 weeks after surgery. Gross observation, histological staining, and scanning electron microscopy were used to evaluate the results at 24 weeks postoperatively.
The time required to perform the vascular anastomosis was significantly shorter for the magnetic device than for hand sewing. A continuity of re-endothelialization was confirmed in all anastomotic stomas after 24 weeks, and neither formation of aneurysms nor thickening of the vascular wall was noted. The re-endothelialization was smooth at the anastomotic site of the magnetic device, whereas hand sewing resulted in rough and uneven re-endothelialization and the presence of visible sutures. Moreover, the endothelial cells were regularly arranged at the anastomotic site of the magnetic device, whereas different-sized and irregularly aligned endothelial cells were present at the hand-sewn anastomotic site. Use of the magnetic device was associated with significantly decreased deposition of fibrotic collagen and depressed infiltration of inflammatory cells compared with use of the hand-sewing technique.
The magnetic pinned-ring device offers a simple, fast, reliable, and efficacious technique for nonsuture vascular anastomosis. Use of this device shortens operation time, maintains a high patency rate, and improves the healing of vascular tissue.
本研究的目的是评估用于非缝合血管吻合术的磁性固定环装置的性能。
磁性固定环装置由成对的磁环组成，磁环涂有氮化钛并嵌入聚丙烯外壳中；这些环配有交替间隔的孔和钛钉。使用新型磁性固定环装置对14只杂种犬进行血管吻合术，另外14只犬采用传统手工缝合技术。在股动脉和下腔静脉进行原位端端吻合。在术后长达24周的不同时间点通过超声扫描确认通畅情况。术后24周采用大体观察、组织学染色和扫描电子显微镜评估结果。
与手工缝合相比，磁性装置进行血管吻合所需的时间明显更短。24周后，所有吻合口均证实有再内皮化的连续性，未发现动脉瘤形成或血管壁增厚。磁性装置吻合部位的再内皮化很平滑，而手工缝合导致再内皮化粗糙且不均匀，并有可见缝线。此外，磁性装置吻合部位的内皮细胞排列规则，而手工缝合吻合部位存在大小不同且排列不规则的内皮细胞。与手工缝合技术相比，使用磁性装置可使纤维化胶原蛋白的沉积显著减少，炎症细胞浸润也减少。
磁性固定环装置为非缝合血管吻合术提供了一种简单、快速、可靠且有效的技术。使用该装置可缩短手术时间，保持较高的通畅率，并改善血管组织的愈合。
