The Double Stitch Everting Technique in the End-to-Side Microvascular Anastomosis: Validation of the Technique Using a Randomized N-of-1 Trial
The Double Stitch Everting Technique in the End-to-Side Microvascular Anastomosis: Validation of the Technique Using a Randomized N-of-1 Trial
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DOI：
10.1055/s-0040-1718548
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发表时间：
2020-10-14
影响因子：
2.1
通讯作者：
Volovici, Victor
中科院分区：
文献类型：
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作者：
Dindelegan, George C.;Dammers, Ruben;Volovici, Victor
背景 双缝外翻 (DSE) 技术是通过在缝合之间将针留在血管壁内来赢得时间，是对端侧 (ETS) 吻合术的改进，旨在减少吻合时间。这确保了适当的壁外翻、内膜与内膜接触以及改善的缝合对称性。材料和方法我们设计了一项N-of-1随机试验，每个显微外科医生作为自己的对照。我们邀请了 10 名具有不同经验水平的显微外科医生，然后要求他们在鸡腿和大鼠股骨模型上进行经典和 DSE ETS 吻合术。每个吻合口均被切割并使用盲法评估进行评估。采用双向方差分析(ANOVA)和多变量Logistic回归分析结果并进行混杂因素调整。结果 共进行吻合210例，其中鸡腿吻合177例，大鼠股动静脉吻合43例。在 210 例吻合术中，111 例使用经典技术进行，99 例使用 DSE 技术进行。经典组的平均吻合时间为 28.811.3 分钟，DSE 组的平均吻合时间为 24.6 +/- 12 分钟（p
Background The double stitch everting (DSE) technique, in which time is won by leaving the needle inside the vessel wall in-between stitching, is a modification of the end-to-side (ETS) anastomosis in the interest of reducing anastomosis time. This ensures proper wall eversion, intima-to-intima contact, and improved suture symmetry.Materials and Methods We designed an N-of-1 randomized trial with each microsurgeon as their own control. We included 10 microsurgeons of different levels of experience who were then asked to perform classic and DSE ETS anastomoses on the chicken leg and rat femoral models. Every anastomosis was cut and evaluated using blinded assessment. Two-way analysis of variance (ANOVA) and multivariable logistic regression were used to analyze the results and for confounder adjustment.Results A total of 210 anastomoses were performed, of which 177 on the chicken leg and 43 on the rat femoral artery and vein. From the 210 anastomoses, 111 were performed using the classic technique and 99 using the DSE technique. The mean anastomosis time was 28.811.3minutes in the classic group and 24.6 +/- 12minutes in the DSE group ( p