Cao Zhuping, Liu Shiqi, Lei Peng, Lv Yi, Wu Rongqian, Ma Feng, Wang Haohua, Luo Ruixue
Department of Nursing, The Affiliated Northwest Women's and Children's Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Department of Neonatal Surgery, The Children Hospital of Xi'an City, Xi'an, Shaanxi, China.
Ann Vasc Surg. 2020 Oct;68:487-496. doi: 10.1016/j.avsg.2020.04.062. Epub 2020 May 16.
The resection and reconstruction of the vena cava is frequently needed in tumor resection. The goal of this study was to evaluate the performance of the magnetic compression anastomosis (MCA) device for fast nonsuture anastomosis of caval reconstruction with artificial blood vessel transplantation after resection in canines.
The MCA device consisted of paired neodymium-ferrum-boron (Nd-Fe-B) magnetic rings that were coated with titanium nitride and embedded in a polypropylene shell. Artificial blood vessel transplantation procedure was performed in sixteen canines and then they were divided into 2 groups: MCA group (n = 8), in which the novel magnetic pinned-ring device was used, and the traditional manual suture group (n = 8). In situ artificial blood vessel anastomoses were performed in the inferior vena cava (IVC). The anastomosis time and anastomotic patency and quality were investigated through ultrasonographic scans, angiographic, gross observation, histological staining, and scanning electron microscopy at 24 weeks postoperatively.
The IVC anastomoses were reconstructed successfully in all canines and all animals survived. In the MCA group, the operation time for IVC anastomosis with artificial blood vessel was significantly shorter than that in the tradition manual suture group (P < 0.05). Vena cava angiography and ultrasound showed good blood patency. The scanning electron microscope showed the re-endothelialization was smooth and endothelial cells were arranged regularly at the anastomotic site. Histological examination confirmed that the MCA group was associated with infiltration of inflammatory cells compared with the manual suture group.
The MCA device combined with artificial blood vessels is applicable in reconstruction of large vessels after resection. The magnetic pinned-ring device offers a simple, fast, reliable, and effective technique for nonsuture artificial blood vessel anastomosis of caval reconstruction in canines, and the anastomosis is functionally better than the traditional sutured anastomosis.
肿瘤切除术中经常需要进行腔静脉的切除与重建。本研究的目的是评估磁压缩吻合（MCA）装置在犬类切除术后用人造血管移植进行腔静脉重建快速非缝合吻合的性能。
MCA装置由成对的钕铁硼（Nd-Fe-B）磁环组成，磁环表面涂有氮化钛并嵌入聚丙烯外壳。对16只犬进行人造血管移植手术，然后将它们分为2组：MCA组（n = 8），使用新型磁性固定环装置；传统手工缝合组（n = 8）。在下腔静脉（IVC）进行原位人造血管吻合。术后24周通过超声扫描、血管造影、大体观察、组织学染色和扫描电子显微镜检查吻合时间、吻合通畅性和质量。
所有犬的IVC吻合均成功重建，所有动物均存活。在MCA组中，用人造血管进行IVC吻合的手术时间明显短于传统手工缝合组（P < 0.05）。腔静脉血管造影和超声显示血液通畅良好。扫描电子显微镜显示吻合部位再内皮化光滑，内皮细胞排列规则。组织学检查证实，与手工缝合组相比，MCA组有炎性细胞浸润。
MCA装置与人造血管结合适用于切除术后大血管的重建。磁性固定环装置为犬类腔静脉重建的非缝合人造血管吻合提供了一种简单、快速、可靠且有效的技术，并且该吻合在功能上优于传统的缝合吻合。
