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磁吻合技术实现门静脉快速无缝线吻合动物实验研究

ISSN号：1007-8118
期刊名称：中华肝胆外科杂志
时间：2013.12.4
页码：758-761
分类：R616[医药卫生—临床医学;医药卫生—外科学]
作者机构：[1]西安交通大学医学院第一附属医院肝胆外科,710061, [2]新疆石河子大学第一附属医院普外三科, [3]宁夏医科大学一附院肝胆外科, [4]西安交通大学医学院护理系, [5]陕西省人民医院肿瘤外科
相关基金：国家自然科学基金（30830099）
相关项目：分散式磁锚定腹腔内手术机器人的研制

关键词：磁压榨吻合技术, 无缝线吻合, 门静脉, 血管吻合, Magnetic compression anastomosis, Sutureless anastomosis technique, Portal vein , Vascular anastomosis

中文摘要：

目的研究一种能快速完成门静脉（PV）端-端吻合的磁性血管吻合器，利用磁吻合技术（MCA）达到肝移植术中PV快速吻合目的。方法西安近郊杂种犬16只按照PV吻合方式不同随机分为MCA组与手工缝合组。比较磁吻合与手工缝合技术吻合PV的效果，观察两组吻合时间、术中吻合口渗漏血情况。术后彩色多普勒超声与血管造影检查观察吻合口血流及并发症情况。结果MCA组较手工缝合组血管吻合耗时明显缩短[（3．55±2．11）min比（13．25±2．74）min；P〈0．01]。MCA组术中吻合口无渗漏血发生，手工缝合组有5例出现吻合口渗漏血并发症。血管x线造影与彩色多普勒超声检查显示MCA组吻合口血流通畅，无狭窄及血栓形成；手工缝合组术后1～4周时2例发生吻合口轻度狭窄并发症。结论MCA是一种简单、快速、效果可靠的血管吻合技术，可减少由于传统手工缝合方法导致的吻合口并发症，改善吻合口质量，有利于手术后恢复。

英文摘要：

Objective To evaluate the magnetic pinned-ring device for non-suture vascular anastomosis. Methods Sixteen adult mongrel dogs of either gender were randomly divided into two groups for portal vein （PV） in situ end-to-end anastomosis. The magnetic compressive anastomosis （MCA） group （n= 8） used magnetic rings for PV reconstruction, and the hand-sewn group （n=8） used hand suturing for PV reconstruction. Operation time and stoma errhysis were recorded. Patency and stoma stenosis was confirmed via color Doppler ultrasound scans and X-ray cholangiography at different time points as late as 4 weeks after surgery. Results The time required to perform the vascular anastomosis was significantly shorter for the magnetic device than for hand sewing [-（3.55 ± 2.11） min vs （13.25±2.74） min; P〈0.01]. 5 cases had stoma errhysis during PV hand-sewing anastomosis that had to be repaired, but no stoma errhysis occurred in the MCA group. Vascular X-ray angiography and color Doppler ultrasound found blood flow to he normal and without stoma stenosis in the magnet- ic anastomosis group, but there were 2 stoma stenoses in the hand sewn group. Conclusions The magnetic ring device offers a simple, fast, reliable, and efficacious technique for non-suture vas- cular anastomosis. Application of the MCA technique can effectively reduce the complication caused by operation technique, resulting in a smoother operation and improved prognosis.

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