Kao L W, Giles H R
Department of Obstetrics and Gynecology, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Obstet Gynecol. 1993 Jan;81(1):122-6.
To assess laser-assisted anastomosis in fallopian tube reconstruction.
Fifty-two rabbit uterine tubes were transected and subjected to laser welding or to microsurgical or laser-assisted anastomosis in a randomized paired design, and compared with the contralateral side. The time required for the procedure, patency of the uterine tubes, amount of adhesion formation, and quality of scar tissue (grossly and histologically) were evaluated 4 weeks after surgery.
Traditional microsurgical procedures required significantly longer operative time than laser-assisted anastomosis (64.4 +/- 2.2 versus 41.3 +/- 2.2 minutes) or laser welding (47.8 +/- 3.0 versus 24.5 +/- 3.0 minutes). Patency was established in all 52 uterine tubes. Adhesion formation was animal-dependent rather than procedure-dependent. All scars healed well and most were not visible beyond residue suture. Inflammatory cells were noted around the suture sites; however, gross observation revealed that all mucosal surfaces over the scars were smooth. One of 18 laser-welded uterine tubes developed dehiscence, whereas there was no dehiscence in laser-assisted or microsurgically anastomosed uterine tubes.
Laser-assisted anastomosis is superior to laser welding or microsurgical anastomosis in rabbit uterine tubes. Laser-assisted anastomosis has potential use in fallopian tube reconstruction.
评估激光辅助吻合术在输卵管重建中的应用。
将52只兔的子宫输卵管切断,采用随机配对设计,分别进行激光焊接、显微手术或激光辅助吻合术,并与对侧进行比较。术后4周评估手术所需时间、输卵管通畅情况、粘连形成量以及瘢痕组织质量(大体和组织学)。
传统显微手术所需手术时间显著长于激光辅助吻合术(64.4±2.2分钟对41.3±2.2分钟)或激光焊接(47.8±3.0分钟对24.5±3.0分钟)。所有52条子宫输卵管均实现通畅。粘连形成取决于动物个体而非手术方式。所有瘢痕愈合良好,大多数在残留缝线之外不可见。在缝线部位周围可见炎性细胞;然而,大体观察显示瘢痕上方所有黏膜表面均光滑。18条接受激光焊接的子宫输卵管中有1条发生裂开,而接受激光辅助吻合术或显微手术吻合术的子宫输卵管未出现裂开。
在兔子宫输卵管中,激光辅助吻合术优于激光焊接或显微手术吻合术。激光辅助吻合术在输卵管重建中具有潜在应用价值。