微血管耦合器在头颈部游离皮瓣手术中挽救性动脉吻合中的应用：病例系列及文献综述
Utilization of microvascular couplers in salvage arterial anastomosis in head and neck free flap surgery: Case series and literature review.
作者信息
Li Michael M, Tamaki Akina, Seim Nolan B, Kang Stephen Y, Ozer Enver, Agrawal Amit, Old Matthew O
机构信息
Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
出版信息
Head Neck. 2020 Aug;42(8):E1-E7. doi: 10.1002/hed.26139. Epub 2020 Mar 20.
BACKGROUND
In microvascular reconstruction of ablative oncologic defects, coupler devices have traditionally been used for venous anastomosis, whereas the arterial anastomosis is hand-sewn. In the setting of repeated intraoperative arterial anastomotic thrombosis, a coupler device may be of use in reducing the risk of rethrombosis.
METHODS
Two patients were seen with advanced stage head and neck cancer and underwent oncologic resection. During microvascular reconstruction, a clot at the arterial anastomosis was encountered in both cases.
RESULTS
After starting therapeutic anticoagulation and attempting unsuccessful suture reanastomosis, coupler devices were used for arterial anastomosis, resulting in viable free-tissue transfer.
CONCLUSIONS
Although traditionally used for venous anastomosis, coupler devices may serve a purpose in the salvage setting when facing repeated intraoperative arterial thrombosis.
背景
在肿瘤切除术后缺损的微血管重建中，传统上耦合器装置用于静脉吻合，而动脉吻合则采用手工缝合。在术中反复出现动脉吻合口血栓形成的情况下，耦合器装置可能有助于降低再次血栓形成的风险。
方法
两名晚期头颈癌患者接受了肿瘤切除手术。在微血管重建过程中，两例均在动脉吻合处出现血栓。
结果
在开始治疗性抗凝并尝试缝合再吻合未成功后，使用耦合器装置进行动脉吻合，实现了游离组织的存活移植。
结论
尽管耦合器装置传统上用于静脉吻合，但在面对术中反复出现动脉血栓形成的挽救情况下，它可能会发挥作用。
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