Non-suturing microvascular anastomosis in maxillofacial reconstruction- a comparative study
Non-suturing microvascular anastomosis in maxillofacial reconstruction- a comparative study
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DOI：
10.1016/j.jcms.2020.04.005
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发表时间：
2020-06-01
影响因子：
3.1
通讯作者：
Raja, V. B. Krishna Kumar
中科院分区：
文献类型：
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作者：
Mudigonda, Surya Kiran;Murugan, Senthil;Raja, V. B. Krishna Kumar
目的：本研究的目的是比较的优点和缺点，非吻合的方法比传统的microvasculo-venous anastomosis.Materials和方法：所有患者报告的硬组织和软组织重建研究所（小学/中学）参加了这项研究。有全身合并症、外周血管疾病或指定供体部位解剖学畸变的患者被排除在研究之外。选择用于研究的患者被随机分配到5组不同的静脉吻合技术，即组I（传统微血管吻合术）、组II（纤维蛋白密封胶增强微血管吻合术）、组III（耦合器）、组IV（吻合器）、组V（激光辅助血管吻合术（LAVA））。术中吻合时间，皮瓣缺血时间，通畅性和泄漏的参数进行了评估为所有五groups.Results：80例患者被随机分配到五组，每组16例。组I和组II的平均缺血时间和标准差分别为256.19 ± 10.622 min和255.19 ± 11.083 min，组III、组IV和组V分别为193.38 ± 9.972 min、139.06 ± 6.413 min，和139.31 ± 6.364 min（p < 0.001）。组I的平均吻合时间和标准差为19.813 +/- 1.5366 min，组II为20.281 +/- 1.6514 min。非缝合吻合组III、IV和V的平均吻合时间分别为5.375 +/- 0.9876 min、4.175 +/- 0.7664 min和3.856 +/- 0.867 min（p值< 0.001）。在第I组和第II组中，18.8%的患者出现延迟通畅，在第III、IV和V组中，所有受试者均观察到即刻通畅（p值0.030）。在第I组和第II组中，分别有18.8%和6.3%的患者发生了吻合口瘘，而第III、IV、V组中的所有患者均未发生吻合口瘘（p值0.119）。结论：根据研究结果，在适用于静脉吻合时，应首选非吻合技术而非微吻合技术。(C)2020年欧洲颅颌面外科协会。由爱思唯尔有限公司出版。保留所有权利。
Aim: The aim of the study is to compare the advantages and disadvantages of non-suturing anastomotic methods over conventional microsuturing for microvascular venous anastomosis.Materials and methods: All patients reporting to the institute for hard and soft tissue reconstruction (Primary/secondary) were enrolled in the study. Patients with systemic comorbidities, peripheral vascular diseases, or anatomical aberration of the indicated donor site were excluded from the study. The patients selected for the study were randomly allocated to five groups of different techniques of venous anastomosis, namely Group I (conventional microsuturing), II (fibrin sealant reinforced microsuturing), III (couplers), IV (staplers), V (Laser Assisted Vascular Anastomosis (LAVA)). Intraoperative anastomotic time, flap ischaemic time, patency and leakage were the parameters that were assessed for all five groups.Results: 80 Patients were randomly allocated to five groups and each group comprised 16 patients. The mean ischaemic time and standard deviation of Group I and Group II were 256.19 +/- 10.622 min and 255.19 +/- 11.083 min, and for groups III, IV, and V were 193.38 +/- 9.972 min, 139.06 +/- 6.413 min, and 139.31 +/- 6.364 min respectively (p < 0.001). Mean anastomotic time and standard deviation were 19.813 +/- 1.5366 min in Group I and 20.281 +/- 1.6514 min in Group II. The non-sutured anastomosis groups III, IV, and V showed a mean anastomotic time of 5.375 +/- 0.9876 min, 4.175 +/- 0.7664 min, and 3.856 +/- 0.867 min respectively (p value < 0.001). In Groups I and II, 18.8% of patients had delayed patency and in Groups III, IV and V, immediate patency was observed in all subjects (p value 0.030). In Groups I and II, 18.8% and 6.3 % of patients respectively had leakage, whereas all patients in Groups III, IV, V had no leakage from the anastomotic site (p value 0.119).Conclusion: Based on the results of the study, non-suturing techniques should be preferred over microsuturing technique whenever appropriate for venous anastomosis. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.