JPRAS Open最新文献

{"title":"Squamous cell carcinoma in rare case of Huriez Syndrome: The role of distant flaps","authors":"A. Patrignani ,&nbsp;D. Ribuffo ,&nbsp;A Greco ,&nbsp;F. Lo Torto ,&nbsp;A. Pagnotta","doi":"10.1016/j.jpra.2024.11.014","DOIUrl":"10.1016/j.jpra.2024.11.014","url":null,"abstract":"<div><h3>Context</h3><div>Huriez syndrome is a rare de rmatological condition characterized by severe sclerotic and atrophic changes in the extremities (hands and feet) and an increased tendency to develop squamous cell carcinomas, with no established gold standard for the surgical treatment of these patients, who are difficult to manage due to the inability to perform reconstructions using local flaps.</div></div><div><h3>Clinical Case</h3><div>We report the case of a patient with severe Huriez syndrome who had developed SCC in both the hands and foot over time. After multiple surgeries at other centers, all resulting in recurrences, we planned wide excisions followed by reconstruction using distant flaps. The postoperative course for both reconstructive procedures was complication-free. Follow-up revealed not only an excellent reconstructive outcome but also highlighted the untapped potential of the flap in managing this condition: thanks to its independent vascularization, the flap remained unaffected by the surrounding diseased skin and significantly improved the scaly, atrophic appearance of the affected areas.</div></div><div><h3>Discussion</h3><div>Huriez syndrome is a dermatological condition characterized by a predisposition to developing squamous cell carcinomas. In these patients, it is essential to plan wide excisions that ensure oncological radicality. The reconstruction must be carefully planned, and microvascular flaps can be prioritized.</div></div><div><h3>Conclusion</h3><div>The radial forearm flap has proven effective for reconstruction in individuals with SCC associated with Huriez syndrome. The skin of the flap not only remained unaffected by the surrounding pathology but also induced a previously undescribed benefit on the diseased skin. This oncological-reconstructive approach could become the gold standard in treating these patients.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 180-186"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Lab to Limb: Unraveling Translational Insights and Significance of Animal Models in Lower Extremity Transplantation","authors":"Yalcin Kulahci ,&nbsp;Naga Anvesh Kodali ,&nbsp;Zeynep Demir ,&nbsp;Omer Dirican ,&nbsp;Bedreddin Sazoglu ,&nbsp;Ramu Janarthanan ,&nbsp;Fatih Zor ,&nbsp;Vijay S. Gorantla","doi":"10.1016/j.jpra.2024.11.018","DOIUrl":"10.1016/j.jpra.2024.11.018","url":null,"abstract":"<div><div>The advancements in medicine throughout the twentieth century have been largely attributed to animal studies. The initial step in researching an animal disease is to establish a model closely resembling the clinical circumstances in humans. Consequently, an excellent animal model is essential for almost any experimental research. The aim of this review is to evaluate the current research on animal models for lower extremity transplantation (LET) and determine how pertinent and significant these models are for therapeutic settings. To bring the reader up to date from an allotransplantation standpoint, we also review, assess, and highlight the noteworthy and intriguing results of the clinical cases performed so far and various animal models. The discussion of their clinical applicability and practicality in the present and future has shed light on the experience with vascularized composite allotransplantation (VCA) around the globe.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 232-244"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total eyebrow reconstruction with a free superficial temporal artery flap: A case report","authors":"Nguyen Van Phung","doi":"10.1016/j.jpra.2024.11.012","DOIUrl":"10.1016/j.jpra.2024.11.012","url":null,"abstract":"<div><div>The eyebrow plays a crucial role in facial aesthetics and expression. Reconstructing an eyebrow defect remains a challenge due to the unique characteristics of eyebrow hair. While various advanced methods exist, we report the first documented use of a free superficial temporal artery flap for total eyebrow reconstruction. This case study describes a successful eyebrow reconstruction in a patient with a total eyebrow defect. The free superficial temporal artery flap provided excellent vascularity, texture, and hair growth, mimicking the natural eyebrow. Our findings suggest that the free superficial temporal artery flap offers a promising new option for reconstructing large eyebrow defects. This technique warrants further investigation in larger patient populations.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 200-204"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive weight loss may facilitate otherwise impossible flap designs in phalloplasty: The first description of a tube-in-tube design of a pedicled SCIA-based flap","authors":"Wouter B. van der Sluis ,&nbsp;Brechje L. Ronkes ,&nbsp;Mark-Bram Bouman","doi":"10.1016/j.jpra.2024.11.015","DOIUrl":"10.1016/j.jpra.2024.11.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Phalloplasty with urethral lengthening (UL) is a complex procedure with a high complication rate.</div></div><div><h3>Case</h3><div>A 44-year-old transgender man with a surgical history of mastectomy, hysterectomy, bilateral oophorectomy, colpectomy and metadoioplasty with UL wished to undergo phalloplasty with UL. He had lost 50 kgs of weight for this procedure. There was substantial skin laxity of the whole abdominal region. A tube-in-tube pedicled SCIA-based flap was designed on the left groin area. The postoperative course was complicated by a dehiscence of the urethra, for which a retubularization was performed 10 months after surgery. At 40 months of clinical follow-up, voiding while standing was possible with good urodynamic function.</div></div><div><h3>Conclusion</h3><div>After massive weight loss, laxity of skin may facilitate otherwise impossible phalloplasty flap designs for phalloplasty.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 164-168"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary-lobe-based trilobed and quadrilobed flaps for reconstruction of nasal tip skin defects","authors":"Olga S. Kaxira,&nbsp;Constantinos H. Tsetsonis","doi":"10.1016/j.jpra.2024.11.011","DOIUrl":"10.1016/j.jpra.2024.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Despite a variety of principles proposed for drawing trilobed and quadrilobed flaps for the reconstruction of nasal skin defects, the application of these principles in a detailed and reliable way remains questionable.</div></div><div><h3>Methods</h3><div>We present a novel method for drawing trilobed and quadrilobed flaps to cover nasal tip skin defects. The method is based on the use of templates corresponding to four trilobed flaps with overall angles of 60°, 70°, 80°, and 90°, and two quadrilobed flaps with angles of 90° and 105°. After applying the templates to the surgical field, the most appropriate one is selected to ensure that the donor defect of the last lobe is closed directly within and parallel to the relaxed skin tension lines, whereas the recipient site and the rest of the donor defects are covered by the lobes in a stepwise manner. Flap design is guided by its corresponding template according to clearly defined geometrical steps, ensuring that the vascular base of the primary lobe supports the rest of the lobes as well.</div></div><div><h3>Results</h3><div>Template-guided flap drawing is an accurate, easy-going, and time-saving process. The base of the flap is the narrowest possible, so the arc of rotation of the flap is the greatest possible. This approach is especially helpful in cases of large tip defects, where the smallest diameter exceeds 2 cm.</div></div><div><h3>Conclusions</h3><div>The use of templates results in the reliable design of highly effective primary-lobe-based trilobed and quadrilobed flaps (PLBT and PLBQ flaps).</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 280-292"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of basal cell carcinoma excision with 2 mm surgical margin in Japanese patients: A retrospective study of one-step surgery","authors":"Kaori Kyono ,&nbsp;Yoshinori Tamada ,&nbsp;Michito Ara ,&nbsp;Shin-Ichiro Yamagishi ,&nbsp;Ayako Higuchi ,&nbsp;Keiichiro Iida ,&nbsp;Naoko Wada ,&nbsp;Makoto Mikami ,&nbsp;Satoshi Urushidate","doi":"10.1016/j.jpra.2024.11.010","DOIUrl":"10.1016/j.jpra.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Basal cell carcinoma is the most common skin malignancy. The standard treatment is surgical excision with predetermined margins. Some argue that the currently recommended surgical margins are excessive, and it is questionable whether such wide surgical margins should be applied to all lesions. We statistically investigated excisions with narrow margins and tried to identify the risk factors for recurrence after one-step surgery.</div></div><div><h3>Methods</h3><div>Basal cell carcinomas were excised at a single institute in Japan over a six-year period and the recurrence rates were retrospectively analyzed using pathological reports and case notes. We reviewed the microscopic findings of the excised specimens and examined the excisional margin status, tumor subtype, and perineural invasion.</div></div><div><h3>Results</h3><div>Forty-eight basal cell carcinomas (45 primary and 3 recurrent) that were identified in Japanese patients were included in this study. Among the primary lesions, well-pigmented and well-defined lesions did not show any involvement of the surgical margins, perineural invasion, or development of local recurrence. Recurrent lesions were significantly associated with positive surgical margins (side margin, P&lt;0.01; deep margin, P&lt;0.01) during the primary operation; however, no association was found with local recurrence after re-resection. Significant differences were observed in perineural invasion and the tumor subtype, especially in the aggressive subtype (P&lt;0.05).</div></div><div><h3>Conclusions</h3><div>A 2 mm margin allows for the safe excision of primary lesions with well-pigmented and well-defined basal cell carcinoma in Japan. Recurrent lesions can be treated with narrow margins by reconstruction after confirmation of a negative margin, instead of performing a common resection with wide margins.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 216-226"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free jejunal transplantation in a patient with short neck, cervical spondylosis, and vascular calcification: A case report","authors":"Naoki Matsuura,&nbsp;Yusuke Shimizu,&nbsp;Edward Hosea Ntege,&nbsp;Reiko Asato,&nbsp;Shohei Ishihara,&nbsp;Rikako Matsuura","doi":"10.1016/j.jpra.2024.11.009","DOIUrl":"10.1016/j.jpra.2024.11.009","url":null,"abstract":"<div><div>Total pharyngo-laryngo-esophagectomy (TPLE) with free jejunal transplantation (FJT) is the standard reconstructive procedure for hypopharyngeal cancer, typically utilizing the superior thyroid artery as the recipient vessel. However, patient-specific anatomical variations and comorbidities can significantly complicate this surgery. We present a unique case of a 68-year-old male with hypopharyngeal cancer who exhibited multiple challenges, including short stature (126 cm), low weight (35 kg), cervical spondylosis, and a history of vertebroplasty, highlighting the complexities inherent in such reconstructions.</div><div>Following preoperative chemotherapy, the patient underwent TPLE and bilateral neck lymph node dissection. Due to the patient's short neck and severe calcification of the external carotid artery, the left transverse cervical artery (TCA) was selected for vascular anastomosis. A jejunal segment was harvested and precisely trimmed using indocyanine green (ICG) fluorescence imaging to optimize blood flow.</div><div>The procedure was successfully completed without complications. The patient resumed oral intake two weeks postoperatively and was discharged one month after surgery. Adjuvant radiation and chemotherapy were subsequently administered. At the six-month follow-up, there was no evidence of tumor recurrence, and the patient maintained a soft food diet.</div><div>This case demonstrates the effectiveness of employing the TCA and ICG fluorescence imaging in FJT for patients with complex cervical anatomy. This approach holds the potential to prevent severe complications such as tetraplegia secondary to myelopathy. To our knowledge, this is the first reported case detailing such a complex reconstruction in a patient presenting with this specific constellation of anatomical challenges. Our findings offer valuable insights for managing difficult head and neck reconstructive surgeries.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 265-270"},"PeriodicalIF":1.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of lower extremity edema following inguinal lymphadenectomy: A systematic review and meta-analysis","authors":"Brett A. Hahn ,&nbsp;Milan C. Richir ,&nbsp;Arjen J. Witkamp ,&nbsp;Tim de Jong ,&nbsp;David D. Krijgh","doi":"10.1016/j.jpra.2024.11.001","DOIUrl":"10.1016/j.jpra.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Lower extremity lymphedema (LEL) can develop because of inguinal lymph node dissection in the treatment of gynecologic, genitourinary, and dermatological malignancies. To optimize patient counseling and patient selection for microsurgical interventions aimed at preventing or treating LEL, its prevalence and associated patient characteristics must be accurately documented. This systematic review and meta-analysis provides a comprehensive overview of literature on the reported prevalence of LEL in patients undergoing inguinal lymphadenectomy.</div></div><div><h3>Methods</h3><div>From Embase, PubMed, and Web of Science databases, 23 studies were identified that met the inclusion criteria. This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Risk of bias was assessed using the Risk of Bias in Non-randomized Studies-of Exposure tool.</div></div><div><h3>Results</h3><div>Random-effects meta-analyses of proportions estimated a 24% (95% confidence interval [CI]: 17-31) pooled prevalence of LEL with a high degree of heterogeneity between the studies (<em>I²</em>=96%, <em>p</em> &lt; 0.01). Subgroup analysis revealed significant differences in LEL prevalence based on the indications for inguinal lymphadenectomy. The pooled LEL prevalence was 25.75% (95% CI: 0.00-96.16) for patients who underwent lymphadenectomy for melanoma, 12.22% (95% CI: 1.03-23.40) for penile cancer, 30.96% (95% CI: 21.08-40.84) for vulvar cancer, and 13.62% (95% CI: 0.00-51.02) for miscellaneous indications.</div></div><div><h3>Conclusion</h3><div>The findings from this study emphasize the importance of considering malignancy etiology when assessing the risk of LEL following inguinal lymphadenectomy. This knowledge could aid physicians in informing patients about the risk of LEL, while also facilitating proper patient selection for microsurgical interventions.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 187-199"},"PeriodicalIF":1.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extensive scalp soft-tissue reconstruction with free flaps: A simplified therapeutic algorithm for donor site selection based on a retrospective analysis","authors":"Raúl Martínez Peral,&nbsp;Josep Oriol Roca Mas,&nbsp;Gonzalo Joaquín Soroa Moreno,&nbsp;Adela Álvarez Río,&nbsp;Antonio Ansó Jiménez,&nbsp;Daniel Navarro Sánchez,&nbsp;Ivan Monge Castresana,&nbsp;Jaime Estrada Cuxart","doi":"10.1016/j.jpra.2024.11.003","DOIUrl":"10.1016/j.jpra.2024.11.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Extensive scalp defects present a significant reconstructive challenge due to the complex needs of patients that are often beyond the scope of conventional therapies, which makes free flaps the most reliable solution. Despite the variety of free flaps available for such cases, there is a lack of clear criteria for selecting the most suitable option. The primary objective of this study was to provide a simplified guide for the selection of donor sites for free flaps for achieving optimal reconstruction outcomes.</div></div><div><h3>Materials and Methods</h3><div>A retrospective study was conducted on 15 patients who underwent scalp reconstruction with free flaps between 2017 and 2022: 4 latissimus dorsi (LD), 4 omental (OM), 5 anterolateral thigh (ALT), and 2 radial forearm free (RFF) flaps. Reconstructive and postoperative data for all patients were collected, evaluated, and compared.</div></div><div><h3>Results</h3><div>The mean defect size to be restored was 110.60 ± 14.55 cm² (LD 162.23 ± 23.1 cm², OM 141.68 ± 11.80 cm², ALT 73.83 ± 14.69 cm², and RFF 37.13 ± 4.88 cm²). Seven complications were reported, with partial flap loss being the most common: LD <em>n</em> = 2 and OM = 3. Mean healing time of the donor and recipient sites was 2.53 ± 0.27 and 1.8 ± 0.31 months, respectively, with OM having the longest average period for recipient site healing (3.65 ± 0.24 months).</div></div><div><h3>Conclusion</h3><div>Reconstructing extensive scalp defects requires careful consideration of critical factors such as defect size, donor tissue availability, need for adjuvant therapies, and patient comorbidities when selecting a flap. This underscores the importance of tailored approaches to enhance clinical outcomes. We propose a simplified algorithm for free flap selection to streamline the decision-making process in complex cases.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 205-215"},"PeriodicalIF":1.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microanastomosis in large vessel size discrepancies: A novel training model","authors":"Hector Oyonate,&nbsp;Jordi Descarrega,&nbsp;Manuel Fernandez Garrido,&nbsp;Joan Fontdevila","doi":"10.1016/j.jpra.2024.11.002","DOIUrl":"10.1016/j.jpra.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Different vessel diameters may challenge the completion of a high-quality anastomosis in microsurgery. In clinical practice, discrepancies in vessel size are commonly encountered. These variations can range from small to moderate, and microsurgeons typically employ established techniques, such as dilating the smaller vessel or creating an oblique cut in its wall, to address these differences. However, when confronted with larger size discrepancies, there is a lack of consensus on the optimal technique, leading surgeons to rely on their individual experiences. Although various anastomotic techniques have been proposed in recent decades, the absence of a standardised model for practicing large vessel size discrepancy anastomosis has limited comparative research.</div><div>Our objective was to develop a new experimental model for practicing large vessel size discrepancy anastomosis using a live rat model.</div></div><div><h3>Material and Methods</h3><div>Thirty adults Winstar® rats were used to develop a novel training model, the aortofemoral anastomosis, which provides two arterial vessels with a large size discrepancy. Thirty aortofemoral anastomoses were performed using the tapered end-to-end technique by the same operator in an experimental surgery laboratory.</div></div><div><h3>Results</h3><div>The tapered end-to-end anastomosis technique achieved permeable anastomoses in all 30 models, as assessed using a patency test after 3 h of completion.</div></div><div><h3>Conclusion</h3><div>The tapered end-to-end anastomotic technique demonstrated satisfactory results in training and clinical practice. However, further research is needed to compare the different anastomotic techniques and determine the optimal approach for large vessel size discrepancies. The aortofemoral anastomosis model stands as a valuable tool for conducting such comparative studies, contributing to the enhancement of microsurgery.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 245-250"},"PeriodicalIF":1.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}