磁压榨吻合技术实现犬腹主动脉人工血管置换快速无缝线吻合

Rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis technique

目的探讨利用磁压榨吻合(MCA)技术实现犬腹主动脉人工血管置换快速无缝线吻合的可行性。方法选择成年健康杂交犬12只,按腹主动脉与人工血管吻合方式分为MCA组和手工缝合(HS)组,每组6只。比较两组术中腹主动脉阻断时间、术中吻合口情况与术后吻合口影像学检查情况。结果MCA组腹主动脉阻断时间短于HS组[(5.2±2.3)min比(24.4±4.3)min],差异有统计学意义(P<0.001)。MCA组术中吻合口无渗漏血及狭窄情况发生;HS组术中6只犬均发生吻合口渗漏血,其中1只犬因失血过多死亡,2只犬因反复修补而出现吻合口轻度狭窄。MCA组术后彩色多普勒超声与血管造影检查显示吻合口血流通畅,无狭窄及血栓形成,HS组术后4周时血管造影检查共发现4只犬吻合口狭窄。结论利用MCA技术可实现犬腹主动脉人工血管置换快速无缝线吻合,减少吻合口并发症的发生,有利于术后恢复。

Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis(MCA)technique.Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing(HS)groups according to the anastomosis method between abdominal aorta and artificial blood vessels.The intraoperative duration of abdominal aorta occlusion,intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups.Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group[(5.2±2.3)min vs.(24.4±4.3)min,P<0.001].No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation.Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group.Among them,1 dog died of excessive blood loss,and 2 dogs experienced mild anastomotic stenosis due to repeated repair.Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group.In the HS group,4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks.Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models,which reduces the incidence of anastomotic complications and accelerates postoperative recovery.