Baumgartner N, Dobrin P B, Morasch M, Dong Q S, Mrkvicka R
Loyola University Medical Center, Department of Surgery, Maywood, IL 60153, USA.
J Thorac Cardiovasc Surg. 1996 May;111(5):1063-72. doi: 10.1016/s0022-5223(96)70383-5.
Experiments were performed in dogs to evaluate the mechanics of 26 end-to-end and 42 end-to-side artery-vein graft anastomoses constructed with continuous polypropylene sutures (Surgilene; Davis & Geck, Division of American Cyanamid Co., Danbury, Conn.), continuous polybutester sutures (Novafil; Davis & Geck), and interrupted stitches with either suture material. After construction, the grafts and adjoining arteries were excised, mounted in vitro at in situ length, filled with a dilute barium sulfate suspension, and pressurized in 25 mm Hg steps up to 200 mm Hg. Radiographs were obtained at each pressure. The computed cross-sectional areas of the anastomoses were compared with those of the native arteries at corresponding pressures. Results showed that for the end-to-end anastomoses at 100 mm Hg the cross-sectional areas of the continuous Surgilene anastomoses were 70% of the native artery cross-sectional areas, the cross-sectional areas of the continuous Novafil anastomoses were 90% of the native artery cross-sectional areas, and the cross-sectional areas of the interrupted anastomoses were 107% of the native artery cross-sectional areas (p < 0.05). At physiologic pressures, there were no differences in compliance among the three types of anastomosis. These data suggest that when constructing an end-to-end anastomosis in a small vessel, one should use an interrupted suture line or possibly continuous polybutester suture. Forty-two end-to-side anastomoses demonstrated no differences in cross-sectional areas or compliance for the three suture techniques. This suggests that, unlike with end-to-end anastomoses, when constructing an end-to-side anastomosis in patients any of the three suture techniques may be acceptable.
在犬类动物身上进行了实验，以评估采用连续聚丙烯缝线（Surgilene；Davis & Geck，美国氰胺公司丹伯里分公司，康涅狄格州）、连续聚丁酯缝线（Novafil；Davis & Geck）以及使用这两种缝线之一的间断缝合方式构建的26个端端和42个端侧动静脉移植吻合口的力学性能。构建完成后，将移植血管和相邻动脉切除，在体外以原位长度固定，填充稀硫酸钡悬液，并以25毫米汞柱的步长加压至200毫米汞柱。在每个压力水平下获取X光片。将吻合口的计算横截面积与相应压力下的天然动脉横截面积进行比较。结果显示，对于端端吻合口，在100毫米汞柱时，连续Surgilene吻合口的横截面积为天然动脉横截面积的70%，连续Novafil吻合口的横截面积为天然动脉横截面积的90%，间断吻合口的横截面积为天然动脉横截面积的107%（p < 0.05）。在生理压力下，三种吻合方式的顺应性没有差异。这些数据表明，在构建小血管的端端吻合口时，应使用间断缝合线或可能使用连续聚丁酯缝线。42个端侧吻合口在三种缝合技术的横截面积或顺应性方面没有差异。这表明，与端端吻合不同，在为患者构建端侧吻合口时，三种缝合技术中的任何一种都可能是可接受的。
