Tang J, Godlewski G, Rouy S, Dauzat M, Ovtchnnikoff S, Delacretaz G, Salathé R P
Laboratoire d'Anatomie Expérimentale, Université Montpellier I, Nîmes.
Chirurgie. 1994;120(12):111-6.
Direct diode laser carotid (0.7-1.2 mm) end-to-end microanastomosis versus contro-lateral manual suture microanastomosis (CMA) were performed in 70 Wistar rats. The laser beam-wavelength 830 nm- was transmitted through a micromanipulator and provided a focused spot of 300 microns in diameter. After placement of three 10.0 Ethilon stitches for edge coaptation, the laser anastomosis was performed using laser shots (average 3) of 500 mW power, 4.5 s duration and 700 W/cm2 irradiance each. CMA was performed by six 10.0 stitches. Good vascular flow was confirmed by macroscopic controls, Doppler spectral analysis (n = 548) and digitalized angiography (n = 18) performed from day 0 to day 210. The patency rate (93%) as well as the complication rate (5/66) were similar in both series. Nevertheless light and scanning electron microscopy (n = 82) showed the morphological superiority of laser anastomosis: reendothelialization by day 3 and medial collagen restructuration by day 10 whilst after CMA, the arterial wall repair was delayed and the medial scar occupied by fibrotic tissue. The other advantages of the laser anastomosis were, shorter operating time minimizing organ ischemia (13 min versus 22 min), and slight endothelial trauma reducing thrombogenic risk. The technical advantages of diode laser were pointed out: miniaturization, no special maintenance and decreasing price of diodes.
在70只Wistar大鼠中进行了直接二极管激光颈动脉（0.7 - 1.2毫米）端端显微吻合术与对侧手工缝合显微吻合术（CMA）。波长830纳米的激光束通过显微操作器传输，形成直径300微米的聚焦光斑。在放置三针10.0 Ethilon缝线进行边缘对接后，使用功率500毫瓦、持续时间4.5秒、辐照度700瓦/平方厘米的激光脉冲（平均3次）进行激光吻合。CMA通过六针10.0缝线进行。从第0天到第210天，通过宏观检查、多普勒频谱分析（n = 548）和数字化血管造影（n = 18）确认良好的血管血流。两个系列的通畅率（93%）以及并发症发生率（5/66）相似。然而，光镜和扫描电子显微镜检查（n = 82）显示激光吻合在形态学上具有优势：术后第3天内皮化再生，第10天中膜胶原重构；而CMA术后，动脉壁修复延迟，中膜瘢痕被纤维化组织占据。激光吻合的其他优点包括手术时间更短，使器官缺血最小化（13分钟对22分钟），以及内皮损伤轻微，降低血栓形成风险。指出了二极管激光的技术优势：小型化、无需特殊维护且二极管价格降低。
