Borja-Morant A, Navarro-Vila C, Cuesta-Gil M, Martin-Sastre R
General Hospital Gregorio Marañon, Maxillofacial Surgery Department, Madrid, Spain.
J Craniomaxillofac Surg. 1995 Oct;23(5):305-11. doi: 10.1016/s1010-5182(05)80161-1.
Microvascular reconstructions in the head and neck are usually long operating time procedures. Mechanical anastomotic devices help to reduce operating time and can reduce anastomotic failures avoiding foreign bodies in the lumen of the vessel. One of these systems is the 3M/Precise microvascular anastomotic device, it is a non-absorbable device, however, criticisms of this system have been directed to the fact that pulsation of the vessel wall against a rigid structure could lead to thinning of the vessel wall and aneurysm formation. No aneurysms have been found previously in other experimental models. Our experimental study on the aorta and vena cava of the rat comprises 25 arterial and 25 venous anastomoses. In the arteries, four proximal aneurysms were found, two of these were failures. In the venous anastomoses, no failures were found nor aneurysm formation. The system is very useful for performing clinical end to end venous anastomosis helping to reduce anastomotic failures. Aneurysms have been found in arteries although four different ring sizes were available. The device is less easy to use in them than in veins and sometimes can be difficult to apply, making manual suturing a better choice for clinical arterial anastomosis.
头颈部微血管重建手术通常耗时较长。机械吻合装置有助于缩短手术时间,并能减少吻合失败,避免血管腔内出现异物。其中一种系统是3M/Precise微血管吻合装置,它是一种不可吸收装置,然而,对该系统的批评主要集中在血管壁与刚性结构的搏动可能导致血管壁变薄和动脉瘤形成这一事实上。此前在其他实验模型中尚未发现动脉瘤。我们对大鼠主动脉和腔静脉进行的实验研究包括25例动脉吻合和25例静脉吻合。在动脉吻合中,发现了4例近端动脉瘤,其中2例吻合失败。在静脉吻合中,未发现吻合失败和动脉瘤形成。该系统对于进行临床端端静脉吻合非常有用,有助于减少吻合失败。尽管有四种不同的环尺寸可供选择,但在动脉中仍发现了动脉瘤。该装置在动脉吻合中比在静脉吻合中使用起来更困难,有时难以应用,这使得手工缝合成为临床动脉吻合的更好选择。