利用磁吻合技术实现犬下腔静脉端端吻合  

Rapid and effective sutureless end-to-end IVC anastomosis by magnetic compression anastomosis technique

作　　者：刘仕琪[1] 雷鹏[2] 吕毅[1] 高睿[3] 李建辉[4] 崔晓海[1] 王善佩[1] 向俊西[1] 张前进[1] 

机构地区：[1]西安交通大学医学院第一附属医院肝胆外科,710061 [2]宁夏医科大学一附院肝胆外科 [3]西安交通大学医学院护理系 [4]陕西省人民医院肿瘤外科

出　　处：《中华普通外科杂志》2013年第12期931-934,共4页Chinese Journal of General Surgery

基　　金：国家自然科学重点基金资助项目（30830099）

摘　　要：目的评价一种利用磁性压榨式吻合技术（magnetic compressive anastomosis，MCA）完成腹腔大血管吻合的新型血管吻合器。方法实验杂种犬16只按照下腔静脉吻合方式不同随机分为磁压榨吻合技术（MCA）组与手工缝合组，比较MCA与手工缝合技术吻合下腔静脉（inferior vena cava，IVC）的效果，观察2组吻合时间、术中吻合口渗漏血情况、术后彩色多普勒超声、血管造影与组织学检查观察吻合口血流及并发症情况。结果MCA组血管吻合耗时（3．2±1．2）min较手工缝合组（13．2±2．3）min短（P=0．000）；MCA组术中吻合口无渗漏血发生，手工缝合组有5例出现吻合口渗漏血；血管x线造影与彩色多普勒超声检查显示MCA组吻合口血流通畅，无狭窄及血栓形成；手工缝合组术后1～6周时共发现3例吻合口轻度狭窄。MCA组较手工缝合组血管壁各层有较好衔接，内皮细胞层光滑，无明显增生，血管腔无异物残留，吻合口炎性反应轻微。结论新型磁性吻合环及磁吻合技术提供了一种简单、快速、吻合效果可靠的血管吻合方法，MCA血管吻合术可减少由于传统缝合技术与材料导致的吻合口并发症。Objective To evaluate the magnetic pinned-ring device for non-suture vascular anastomosis in dogs. Methods Sixteen adult mongrel dogs of either gender were randomly divided into two gnoups for IVC in situ end-to-end anastomosis： group MCA （n = 8 ） using magnetic rings for IVC reconstruction, and hand-sewing group （ n = 8 ）. Operation time and anastomotie leaking were recorded. Patency and stoma stenosis was evaluated by color Doppler ultrasound scanning, X-ray cholangiography and histological examination at different time points as late as 6 weeks after surgery. Results The time required to perform the vascular anastomosis was significantly shorter for the magnetic device （ 3.2 ±1.2 ） min than for hand sewing （ 13.2 ± 2. 3 ） min （P = 0. 000）. Anastomotie leaking occurred in 5 dogs in hand- sewing anastomosis group. Vascular X-ray angiography and color Doppler ultrasound identified normal blood flow in magnetic anastomosis group, and no stoma stenosis, while there were 3 stoma stenosis in the manual suture group. Magnetic ring device stoma is superior to manual suturing in smooth re-endothelialization, less fibrotie collagen deposition and depressed infiltration of inflammatory cells at the anastomotie site. Conclusions The magnetic ring device offers a simple, fast, reliable, and efficacious technique for nonsuture vascular anastomosis with satisfactory prognosis.

关 键 词：吻合术 外科 下腔静脉 磁压榨吻合技术 

分 类 号：R-332[医药卫生]