Heidekrueger Paul I, Ninkovic Milomir, Heine-Geldern Albrecht, Herter Frank, Broer P Niclas
a Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen , Academic Teaching Hospital Technical University Munich , Munich , Germany.
J Plast Surg Hand Surg. 2017 Oct;51(5):362-365. doi: 10.1080/2000656X.2017.1283321. Epub 2017 Feb 2.
The choice of microsurgical anastomotic technique, end-to-end (ETE) or end-to-side (ETS), is a relevant point in free tissue transfer. The decision-making process of choosing ETE or ETS technique depends on several clinical and perioperative factors. This study evaluates the outcomes of microvascular procedures in a large single centre patient series, focusing on ETE vs ETS arterial anastomoses.
Between January 2009 and June 2015, 838 patients underwent free flap surgery for reconstruction after trauma, infection, or malignancies. The cases were divided according to the microsurgical technique of the arterial anastomosis into an ETE (n = 693) and an ETS (n = 145) group. The series was retrospectively analysed and the two groups compared regarding outcomes.
Overall, there was no significant difference in rates of surgical complications, flap failures, and re-explorations between the patient groups during the 3-months follow-up period.
The presented analysis includes a large series of microsurgical reconstructions evaluating outcomes in respect to type of performed arterial anastomosis. While the decision of performing an ETE or ETS arterial anastomosis must be made according to recipient vessel quality and accessibility, given no change in outcomes, an ETS anastomosis should be performed whenever feasible in order to preserve distal perfusion.
在游离组织移植中，显微外科吻合技术的选择，即端端吻合（ETE）或端侧吻合（ETS），是一个重要问题。选择ETE或ETS技术的决策过程取决于几个临床和围手术期因素。本研究评估了一个大型单中心患者系列中微血管手术的结果，重点是ETE与ETS动脉吻合。
2009年1月至2015年6月期间，838例患者因创伤、感染或恶性肿瘤后行游离皮瓣手术重建。根据动脉吻合的显微外科技术将病例分为ETE组（n = 693）和ETS组（n = 145）。对该系列进行回顾性分析，并比较两组的结果。
总体而言，在3个月的随访期内，两组患者的手术并发症、皮瓣坏死和再次手术率无显著差异。
本分析纳入了大量显微外科重建病例，评估了所进行的动脉吻合类型的结果。虽然必须根据受区血管质量和可达性来决定进行ETE或ETS动脉吻合，但鉴于结果无差异，只要可行，应尽可能进行ETS吻合以保留远端灌注。
