Vokrri Lulzim, Qavdarbasha Arsim, Rudari Hajriz, Ahmetaj Halil, Manxhuka-Kërliu Suzana, Hyseni Nexhmi, Porcu Paolo, Cinquin Philippe, Sessa Carmine
Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo ; Medical Faculty, University of Pristina, Republic of Kosovo ; Veterinary Institute, Pristina, Republic of Kosovo ; University of Grenoble Alpes/CNRS/TIMC-IMAG UMR 5525 (GMCAO team), Grenoble, 38000, France.
Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo ; Medical Faculty, University of Pristina, Republic of Kosovo ; Veterinary Institute, Pristina, Republic of Kosovo.
Vasc Health Risk Manag. 2015 Mar 27;11:211-7. doi: 10.2147/VHRM.S73104. eCollection 2015.
The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits.
Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment.
Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses.
This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.
本研究的目的是探讨一种使用粘合假体的无缝合血管吻合新技术作为兔唯一吻合固定方法的可行性和有效性。
随机选择10只兔子进行实验。5只兔子采用粘合假体对肾下腹主动脉进行直接吻合。另外5只兔子采用缝合吻合进行重建。所有动物立即通过超声多普勒检查吻合口通畅情况。测量粘合吻合口的破裂压力并与缝合动脉的破裂压力进行比较。实验结束后立即对动物实施安乐死，并取组织样本进行组织学检查。
与传统吻合相比，无缝合血管吻合所需的创建时间更短，失血显著减少（P<5%）。手术结束时两组间通过吻合口的平均血流量无显著差异。通过超声多普勒检查，除1例术后立即出现狭窄外，所有使用粘合假体的吻合口在吻合部位均通畅。在对照组中，除1例狭窄外，所有传统吻合口均通畅。无缝合吻合口处的平均破裂压力低于对照组。宏观上，生物胶未显示出与周围组织有任何粘连，因为它被血管假体覆盖。组织学检查显示，粘合吻合处有低度炎症反应，而缝合吻合处无炎症反应。
该技术可能为血管手术提供一种可行且成功的替代方法。然而，需要进一步的长期研究来阐明吻合部位的破裂压力和炎症程度。
