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Venous and lymphatic anastomosis using a diode laser system

使用二极管激光系统进行静脉和淋巴吻合术

基本信息

批准号：
02454300
负责人：
KONNO Hiroyuki
金额：
$ 2.94万
依托单位：
Hamamatsu University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1992
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-02454300/
关键词：
diode laser venous anastomosis lymphatic anastomosis 半導体レ-ザ-

项目摘要

The usefulness of a new diode laser system(Hamamatsu Photonics Co. Ltd., continuous mode, wavelength; 830nm, ceramic contact probe) for microvascular anastomosis of vein and lymph vessels was studied.The femoral vein of wister rat weighing 250g was transected under microscope and four 10-0 polypropylene stay sutures were placed for edge coaptation. Laser contact probe was touched the anastomotic line to fuse the vein edges 2 - 5 seconds with the power of 60 mW. The laser anastomosis was made in forty rats and the conventional anastomosis with interrupted sutures using 10-0 polypropylene was made in forty rats for control group. The patency was observed for sixteen weeks and the histological examination was also performed in both groups. The anastomosis of lymphatics was made using the lymph vessel in the inguinal region of mongrel dogs(30 - 60 mW, 2 -3 seconds).Patency rates were 95.0% in laser group and 92.5% in control group. Histological examination at two weeks revealed that in laser group intimal cell coverage was completed and the laminar structure of the media was well oriented, on the other hand, in control group, fibrous hyperplasia of the intima and cellular reaction around the suture material were observed. Laser anastomosis of the lymph vessels has technical difficulty to fuse the edges of lymph wall due to penetration or shrinkage of the vessel wall. Furthermore, the histological examination is not enough to observe the change of anastomotic site because of the difficulty to identify the line of anastomosis.Laser amastomosis presents the more physiological wound healing and the characteristic is especially suitable for anastomosis of the veins which are easily thrombosed. Concerning the lymph anastomosis, no satisfactory result was obtained and a new device would be required.

为探讨新型半导体激光系统(滨松光电株式会社，连续模式，波长830 nm，陶瓷接触式探头)在静脉和淋巴管微血管吻合中的应用，在显微镜下横切大鼠股静脉，放置4条10-0聚丙烯拉力缝线进行边缘缝合。激光接触探头触碰到吻合线，以60 mW功率融合静脉边缘2~5s。激光吻合术40只，对照组40只，采用10-0聚丙烯间断缝合常规吻合术。对两组通畅情况观察16周，并进行组织学检查。用30~60 mW、2~3s的杂交犬腹股沟淋巴管进行淋巴管吻合，激光组通畅率95.0%，对照组通畅率92.5%。2周时组织学检查激光组内膜细胞覆盖完整，中膜板层结构定向良好，对照组内膜纤维性增生，缝合材料周围可见细胞反应。淋巴管激光吻合术因淋巴管壁的穿透或收缩而难以融合淋巴壁的边缘。此外，由于难以辨别吻合线，组织学检查不足以观察吻合口位置的变化，激光吻合术呈现出更多的生理性伤口愈合，这一特点特别适合于容易血栓的静脉的吻合。淋巴管吻合术效果不佳，需更换新器械。