Iwasa H, Sato F, Masuzawa T, Shimabukuro H, Yamada N, Ikada Y, Gen S
Department of Surgical Neurology, Jichi Medical School, Tochigi-ken, Japan.
No Shinkei Geka. 1988 May;16(6):727-32.
Experimental microvascular anastomosis using a glutide copolymer (lactide: glycolide = 80: 20) as an external splint was undertaken in rats between the left and the right carotid arteries. Both arteries were dissected free over a 1-cm length, the left carotid artery was transected at the cranial end, and the right carotid artery was cut at the caudal end. The left carotid artery was then introduced into a glutide pipe-splint. The arterial wall was turned back 180 degrees over the edge of the splint. The reflected part of the artery and the glutide were covered with the freed-up right carotid artery. One stitch was made around the two arteries and the glutide in a manner similar to that of binding a barrel with steel wire. The "One-knot anastomosis" was then complete. We call this type of anastomosis "antegrade anastomosis". If, on the other hand, the right carotid artery is introduced into the pipe, turned back at the edge of the glutide, covered with the left carotid artery and secured with one stitch, the technique is known as "retrograde anastomosis". The patency rates of the resulting vessels were as follows: antegrade anastomosis, 83% (15/18); and retrograde anastomosis, 92% (23/25); so that the average patency rate was 88% (38/43). We measured the anastomosing time that is the time between the transection of one of the two arteries and the completion of the anastomosis. The average anastomosing time was 21 minutes for antegrade anastomosis and 14 minutes for retrograde anastomosis. But the 'pure anastomosing time' (the time taken to connect the two already prepared arteries) was 2-3 minutes. We believe that one-knot anastomosis technique for future clinical application is promising.
在大鼠的左右颈动脉之间进行了使用丙交酯共聚物（丙交酯：乙交酯 = 80:20）作为外部夹板的实验性微血管吻合术。将两条动脉游离出1厘米长的一段，左颈动脉在头端横断，右颈动脉在尾端切断。然后将左颈动脉插入丙交酯管型夹板中。动脉壁在夹板边缘处翻转180度。动脉的翻转部分和丙交酯用游离出来的右颈动脉覆盖。以类似于用钢丝捆绑桶的方式在两条动脉和丙交酯周围缝合一针。然后“单结吻合术”完成。我们将这种吻合术称为“顺行吻合术”。另一方面，如果将右颈动脉插入管中，在丙交酯边缘处翻转，用左颈动脉覆盖并用一针固定，这种技术称为“逆行吻合术”。所形成血管的通畅率如下：顺行吻合术为83%（15/18）；逆行吻合术为92%（23/25）；因此平均通畅率为88%（38/43）。我们测量了吻合时间，即两条动脉之一横断至吻合完成之间的时间。顺行吻合术的平均吻合时间为21分钟，逆行吻合术为14分钟。但“纯吻合时间”（连接两条已准备好的动脉所需的时间）为2 - 3分钟。我们认为单结吻合术在未来临床应用中很有前景。
