Aizawa Tetsushi, Kuwabara Masahiro, Kubo Satoshi, Domoto Takashi, Aoki Shimpo, Azuma Ryuichi, Kiyosawa Tomoharu
Department of Plastic and Reconstructive Surgery, National Defense Medical College, Saitama, 359-8513, Japan.
J Reconstr Microsurg. 2018 Jan;34(1):8-12. doi: 10.1055/s-0037-1605587. Epub 2017 Sep 6.
Microvascular anastomosis using cyanoacrylate adhesive has a reputation among researchers as an alternative to conventional sutures. However, a degree of ingenuity is required to avoid the collapse of the vascular lumen for the duration of the anastomosis. The aim of this study was to determine the feasibility of intravascular stenting (IVaS) as a temporary stent during sutureless microvascular anastomosis with cyanoacrylate adhesive.
Sixty male Fisher 344 rats were evenly divided into two groups. The right superficial femoral arteries (RSFAs) were transected in each group. Microvascular anastomoses were then performed with the sutureless (SL) method in one group and conventional sutures (CS) in the other group. The diameter of the RSFA, duration of microvascular anastomosis, and the patency of the RSFA were evaluated immediately after anastomosis and 7 days after the surgery. Tissue samples were obtained for pathological consideration.
There was no significant difference in the diameter of the RSFAs between the SL and the CS groups. There was no significant difference in the patency rates of the groups. The anastomosis time of the SL group was significantly shorter than that of the CS group, regardless of the experience of the surgeons. A histological analysis showed a comparable level of foreign body reactions in each group.
IVaS plays a supportive role in sutureless microvascular anastomosis with cyanoacrylate adhesive. The short-term safety of this technique has now been confirmed at the experimental stage.
在研究人员中，使用氰基丙烯酸酯粘合剂进行微血管吻合术被视为传统缝合方法的一种替代方案。然而，在吻合过程中需要一定的技巧来避免血管腔塌陷。本研究的目的是确定血管内支架置入术（IVaS）作为使用氰基丙烯酸酯粘合剂进行无缝合微血管吻合术时临时支架的可行性。
将60只雄性Fisher 344大鼠平均分为两组。每组均切断右侧股浅动脉（RSFA）。然后，一组采用无缝合（SL）方法进行微血管吻合，另一组采用传统缝合（CS）方法。吻合后立即以及术后7天评估RSFA的直径、微血管吻合持续时间和RSFA的通畅情况。获取组织样本进行病理学分析。
SL组和CS组的RSFA直径无显著差异。两组的通畅率无显著差异。无论外科医生的经验如何，SL组的吻合时间均显著短于CS组。组织学分析显示每组的异物反应水平相当。
IVaS在使用氰基丙烯酸酯粘合剂进行无缝合微血管吻合术中起支持作用。该技术的短期安全性现已在实验阶段得到证实。
