Yamagata S, Handa H, Taki W, Yonekawa Y, Ikada Y, Iwata H
No Shinkei Geka. 1979 Nov;7(11):1067-73.
Microvascular anastomosis is now widely applied and many improved methods of the nonsuture anastomosis have been developed instead of the suture anastomosis for the purpose of saving time and making the reconstruction easier. We introduced a new nonsuture method of microvascular anastomosis using plastic adhesive and a soluble tube made of polyvinylalcohol (PVA). PVA, which had been utilized as a plasma expander, is a water-soluble polymer and its solubility is changeable depending on the degree of polimerization and percent saponification. We have made two kinds of soluble PVA tubes, the one has monolayer wall and the other double layered wall. The inner wall of the latter is more soluble than the outer wall. As plastic adhesives, we employed ethyl 2--cyanoacrylate, isopropyl 2--cyanoacrylate, and isobutyl 2--cyanoacrylate which were much superior to methyl 2--cyanoacrylate. Common carotid arteries of rats of 1.0 to 1.3 mm external diameter range were reconstructed and re-exploration was carried out at intervals of more than 7 days after operation. The anastomotic technique was very easy and it took about five minutes to reconstruct. In our last series, approximately 98 percent patency rate was achieved. The advantage of our method is that the blood stream is regained in the small soluble at the anastomotic site immediately after the release of hemostatic clamps.
微血管吻合术目前已被广泛应用，并且为了节省时间和使重建更容易，已开发出许多改进的非缝合吻合方法来替代缝合吻合术。我们介绍了一种使用塑料粘合剂和由聚乙烯醇（PVA）制成的可溶管的微血管吻合非缝合新方法。曾被用作血浆扩容剂的PVA是一种水溶性聚合物，其溶解度会根据聚合度和皂化百分比而变化。我们制作了两种可溶的PVA管，一种是单层壁的，另一种是双层壁的。后者的内壁比外壁更易溶解。作为塑料粘合剂，我们使用了2-氰基丙烯酸乙酯、2-氰基丙烯酸异丙酯和2-氰基丙烯酸异丁酯，它们比2-氰基丙烯酸甲酯优越得多。对外径范围为1.0至1.3毫米的大鼠颈总动脉进行重建，并在术后7天以上的间隔时间进行再次探查。吻合技术非常简单，重建大约需要5分钟。在我们最后的系列实验中，实现了约98%的通畅率。我们方法的优点是在松开止血夹后，吻合部位的小可溶性管立即恢复血流。
