Özer Fırat, Nişancı Mustafa, Taş Çetin, Rajadas Jayakumar, Alhan Doğan, Bozkurt Yalçın, Günal Armağan, Demirtaş Serdar, Işık Selçuk
Gulhane Military Medical Academy, Department of Plastic Surgery, Ankara, Turkey.
Gulhane Military Medical Academy, Department of Plastic Surgery, Ankara, Turkey.
J Plast Reconstr Aesthet Surg. 2017 Feb;70(2):267-273. doi: 10.1016/j.bjps.2016.10.012. Epub 2016 Nov 12.
Anastomosis with tissue adhesives is an alternative method for conventional anastomosis. However, this method has several technical challenges. It requires the use of suture to prevent leakage into lumen and precise application onto all surfaces of the anastomosis site. To solve these problems, poloxamer 407 (P 407) was previously used as a stent. In this study, we made heparinized P 407 (h-P 407) as a new formula. We aimed to successfully use h-P 407 as a stent in sutureless anastomosis in a rat abdominal aorta model.
Sixty Sprague-Dawley rats were used. In the first group, end-to-end anastomoses were performed with suture; in the second and third groups, sutureless anastomoses were performed with 2-octyl cyanoacrylate. As an intraluminal stent, P 407 was used in the second group, and h-P 407 was used in the third group. Anastomosis time was measured. Lumen width, intimal hyperplasia, and foreign body reaction were assessed histologically. Velocity flow rates and vessel diameters were measured radiologically. Burst strength was measured, and the results were statistically evaluated.
Sutureless anastomosis was more rapid than conventional anastomosis. Lumen width was narrower in the suture group. İnflammation and foreign body reaction were more severe in the suture group. There was no radiologic and biomechanical difference between the groups. We found that intimal hyperplasia was less in h-P 407 than in P 407.
h-P407 can be successfully used as an intraluminal stent for sutureless microvascular anastomosis with tissue adhesives.
使用组织粘合剂进行吻合是传统吻合术的一种替代方法。然而，这种方法存在一些技术挑战。它需要使用缝线来防止漏入管腔，并精确应用于吻合部位的所有表面。为了解决这些问题，泊洛沙姆407（P 407）曾被用作支架。在本研究中，我们制备了肝素化的P 407（h-P 407）作为一种新配方。我们旨在成功地将h-P 407用作大鼠腹主动脉模型中无缝合吻合术的支架。
使用60只Sprague-Dawley大鼠。第一组采用缝线进行端端吻合；第二组和第三组使用2-氰基丙烯酸辛酯进行无缝合吻合。作为腔内支架，第二组使用P 407，第三组使用h-P 407。测量吻合时间。通过组织学评估管腔宽度、内膜增生和异物反应。通过放射学测量流速和血管直径。测量破裂强度，并对结果进行统计学评估。
无缝合吻合比传统吻合更快。缝合组的管腔宽度更窄。缝合组的炎症和异物反应更严重。两组之间在放射学和生物力学方面没有差异。我们发现h-P 407组的内膜增生比P 407组少。
h-P407可以成功地用作与组织粘合剂进行无缝合微血管吻合的腔内支架。
