Usefulness of combined continuous suture and interrupted tie technique in hindlimb composite tissue allotransplantation in rats

Anterior-interrupted and posterior-continuous suture technique improved the success rate of kidney transplantation model in rats

PURPOSE

This study aimed to introduce and evaluate two new microvascular anastomosis techniques compared to the conventional method in a rat renal transplant model.

METHODS

Using a Fisher-to-Lewis rat kidney transplantation model, the renal artery anastomosis was performed using the interrupted (I) suture technique, Y-shaped continuous (Y) suture technique, and anterior-interrupted and posterior-continuous (I-C) suture technique. The rats were then divided into three groups: I group, Y group, and I-C group. Parameters such as arterial anastomosis time, warm ischemia time, seven-day survival rate of the rats, and vessel histopathology were assessed.

RESULTS

The mean arterial anastomosis time, blood leakage scores, and warm ischemia time were significantly reduced in groups Y and I-C compared to group I. Moreover, the seven-day survival rate was significantly higher in the I-C group compared to the other two groups. Arterial histopathology demonstrated vessel wall recovery without damage in all three groups, suggesting the safety of both Y and I-C techniques.

CONCLUSIONS

The anterior-interrupted and posterior-continuous suture method is particularly beneficial for small artery reconstruction in organ transplantation.

Synchronous microsurgical anastomosis in complex replantation surgery

We conducted a retrospective case control study of digital replantations in 16 patients from September 2015 to January 2017. Half of the patients were treated by a synchronous microsurgical technique and the other half underwent conventional micro-anastomoses. The total time for anastomoses, total operation time and survival of digits were the major endpoints in this study. The number of digits replanted and the anastomosis method had significant effects on total anastomosis time. The mean anastomosis time for each digit was 46 min and 70 min in the synchronous and conventional groups, respectively, a 34% reduction in anastomosis time in the synchronous group when compared with the conventional group. Patency rates were 87% (13/15) of all the digits replanted in each group. Level of evidence: IV.

Continuous locked suture technique for arterial anastomosis in rat small bowel transplantation

Continuous locked suture technique in arterial anastomosis was used in a rat heterotopic small bowel transplantation model. Blood loss, time consumption and success rate of the technique, as well as long-term blood flow and histological changes of arterial anastomosis and intestinal graft were compared with the traditional simple continuous suture technique. The results showed that the time consumption was similar between the two techniques while the continuous locked suture technique had a higher success rate (P = 0.016) and was more secure than the simple continuous suture technique. Moreover, it provided a higher long-term blood flow. Under light microscopy and electron scanning microscopy, the anastomosis of continuous locked suture technique showed significantly less stenosis than those of simple continuous suture technique. No difference was found between the two techniques considering the graft intestinal histological changes. In conclusion, the continuous locked suture technique was a more superior technique than simple continuous suture technique in arterial end-to-side anastomosis considering long-term hemodynamics.