Gloviczki P, Le Floch P, Hidden G
J Chir (Paris). 1979 Jun-Jul;116(6-7):437-43.
Since the pioneer work of Nielubowicz et Olszewski successful anastomoses have been caried out between lymphnodes and veins in experiments and in the clinic as well. The creation of patent anastomoses between lymphatic trunks and veins still present many problems, primarily due to the small size of the lymphatic vessels. The microsurgical technique permits the authors to overcome these difficulties. End-to-side anastomosis between lymphatic trunk and the superficial femoral vein was carried out - using stereo microscopic - on rabbits, with a modification of Cordeiro's and Degni's technique; a longitudinally divided plastic catheter was introduced into the vein and the lymphatic trunk was pulled into the lumen and fixed to the upper venous wall with one suture. End-to-end anastomosis was created between lymphatic trunk and the superficial femoral vein or one of it's branches with a technique using a small piece of plastic catheter, which was introduced into the lymphatic trunk on one side and to the vein on the other side in order to prevent the transfixation of the vessels wall. Interrupted 11/0 atraumatic sutures were used to create the anastomosis. With both of these methods patent anatomosis can be carried out between lymphatic trunks and veins.
自涅卢博维奇和奥尔谢夫斯基的开创性工作以来,在实验和临床中都已成功进行了淋巴结与静脉之间的吻合术。在淋巴管干与静脉之间建立通畅的吻合术仍然存在许多问题,主要是由于淋巴管管径细小。显微外科技术使作者能够克服这些困难。在兔子身上采用改良的科代罗和德尼技术,使用体视显微镜进行淋巴管干与股浅静脉之间的端侧吻合;将一根纵向剖开的塑料导管插入静脉,将淋巴管干拉入管腔,并用一根缝线固定于静脉上壁。采用一种使用小块塑料导管的技术,在淋巴管干与股浅静脉或其分支之一之间进行端端吻合,将塑料导管一端插入淋巴管干,另一端插入静脉,以防止血管壁贯通伤。使用11/0无创伤间断缝线进行吻合。通过这两种方法均可在淋巴管干与静脉之间实现通畅的吻合。