Morasch M D, Dobrin P B, Dong Q S, Mrkvicka R
Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
Ann Vasc Surg. 1998 Jan;12(1):55-9. doi: 10.1007/s100169900115.
It previously has been shown that in straight end-to-end artery-to-vein anastomoses, maximum dimensions are obtained with an interrupted suture line. Nearly equivalent dimensions are obtained with a continuous compliant polybutester suture (Novafil), and the smallest dimensions are obtained with a continuous noncompliant polypropylene suture (Surgilene). The present study was undertaken to examine these suture techniques in a spatulated or beveled anastomosis in living dogs. Anastomoses were constructed using continuous 6-0 polypropylene (Surgilene), continuous 6-0 polybutester (Novafil), or interrupted 6-0 polypropylene or polybutester. Thirty minutes after construction, the artery, vein, and beveled anastomoses were excised, restored to in situ length and pressurized with the lumen filled with a dilute suspension of barium sulfate. High resolution radiographs were obtained at 25 mmHg pressure increments up to 200 mmHg. Dimensions and compliance were determined from the radiographic images. Results showed that, unlike straight artery-to-vein anastomoses, there were no differences in the dimensions or compliance of spatulated anastomoses with continuous Surgilene, continuous Novafil, or interrupted suture techniques. Therefore a continuous suture technique is acceptable when constructing spatulated artery-to-vein anastomoses in patients.
此前已有研究表明，在端对端的动脉与静脉直接吻合中，间断缝合线可获得最大尺寸。使用连续的顺应性聚丁酯缝线（Novafil）可获得近乎相同的尺寸，而使用连续的非顺应性聚丙烯缝线（Surgilene）可获得最小尺寸。本研究旨在研究在活体犬的勺状或斜面吻合中这些缝合技术。使用连续的6-0聚丙烯（Surgilene）、连续的6-0聚丁酯（Novafil）、间断的6-0聚丙烯或聚丁酯构建吻合口。构建后30分钟，切除动脉、静脉和斜面吻合口，恢复至原位长度，并用充满硫酸钡稀释悬浮液的管腔加压。以25 mmHg的压力增量直至200 mmHg获取高分辨率射线照片。从射线照片图像确定尺寸和顺应性。结果表明，与端对端的动脉与静脉吻合不同，使用连续的Surgilene、连续的Novafil或间断缝合技术的勺状吻合在尺寸或顺应性方面没有差异。因此，在患者中构建勺状动脉与静脉吻合时，连续缝合技术是可以接受的。
