Size adjustment suture technique for lymphaticovenular anastomosis.

IF 1 4区 医学 Q3 ORTHOPEDICS
Satoshi Onoda, Kahori Tsukura, Toshihiko Satake
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引用次数: 0

Abstract

In this report, we describe a super microsurgical technique that enables rapid and accurate anastomosis while adjusting for caliber differences when anastomosing a small-caliber lymphatic vessel and a vein with a larger caliber, which is frequently encountered in surgeries such as lymphaticovenous anastomosis (LVA).  The suture size adjustment technique was performed in 30 anastomoses of lymphatic vessels and veins, whose diameter of lymph duct was at least two times smaller than that of the vein. The type of lymphedema, caliber of lymphatic vessels and veins anastomosed, caliber ratio, vein wall thickness, modified caliber ratio after vein wall thickness subtracted, presence of additional anastomosis, and anastomosis time were examined. On average, the lymphatic vessels had a diameter of 0.61 mm, while the veins were 1.43 mm in diameter. The mean caliber ratio of vein to lymphatic vessel was 2.3, while the modified caliber ratio of vein-to-lymphatic vessel was 1.5 on average. The average venous wall thickness was 0.51. The average anastomosis time was 9.1 min and no additional anastomosis due to leakage was necessary in any case. We successfully performed an anastomosis of lymphatic vessels and veins with different calibers, which can maintain long-term patency while adjusting the caliber difference and suppressing leakage at the anastomosis site. Finally, the caliber of the vein is commonly larger than that of the lymphatic vessel to be anastomosed in many cases of LVA surgery, indicating that the proposed anastomosis method could be of therapeutic use in many cases.

淋巴管-静脉吻合术的尺寸调整缝合技术。
在本报告中,我们介绍了一种超级显微外科技术,该技术在吻合小口径淋巴管和大口径静脉时,可根据口径差异进行调整,从而实现快速准确的吻合,这在淋巴-静脉吻合术(LVA)等手术中经常遇到。 我们在 30 例淋巴管和静脉吻合术中采用了缝合尺寸调整技术,这些吻合术的淋巴管直径至少比静脉直径小两倍。对淋巴水肿的类型、吻合的淋巴管和静脉的口径、口径比、静脉壁厚度、减去静脉壁厚度后的修正口径比、有无附加吻合口以及吻合时间进行了研究。淋巴管的平均直径为 0.61 毫米,而静脉的直径为 1.43 毫米。静脉与淋巴管的平均口径比为 2.3,而静脉与淋巴管的修正口径比平均为 1.5。静脉壁平均厚度为 0.51。平均吻合时间为 9.1 分钟,没有一例因渗漏而需要额外吻合。我们成功地将不同口径的淋巴管和静脉进行了吻合,在调整口径差异和抑制吻合部位渗漏的同时,保持了长期的通畅性。最后,在许多 LVA 手术病例中,静脉的口径通常大于要吻合的淋巴管的口径,这表明所建议的吻合方法在许多病例中都能起到治疗作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
108
审稿时长
6-12 weeks
期刊介绍: The purpose of the Journal of Plastic Surgery and Hand Surgery is to serve as an international forum for plastic surgery, hand surgery and related research. Interest is focused on original articles on basic research and clinical evaluation. The scope of the journal comprises: • Articles concerning operative methods and follow-up studies • Research articles on subjects related to plastic and hand surgery • Articles on cranio-maxillofacial surgery, including cleft lip and palate surgery. Extended issues are published occasionally, dealing with special topics such as microvascular surgery, craniofacial surgery, or burns. Supplements, usually doctoral theses, may also be published. The journal is published for the Acta Chirurgica Scandinavica society and sponsored by the Key Foundation, Sweden. The journal was previously published as Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.
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