Erratum to bronchial interrupted suture anastomosis for video-assisted thoracic surgery (VATS) right upper lobe resection
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[This corrects the article DOI: 10.21037/jtd.2017.08.21.].Keywords:
Cardiothoracic surgery
The Authors carry out an experimental comparative study on four different suture materials (collagen cromic, polyglactin 910, PDS and nylon), used to perform end-to-end colonic anastomoses. They assess the resistence to the endoluminar pressure. The results show that during the first four days the anastomoses performed with PDS display a vere high resistence, while those with collagen cromic exhibit still lower value than Vicryl and nylon. After eleven days the anastomoses with the PDS show most resistence again, but the other three materials get similar value.
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Objective To compare the application of biofragmentable anastomosis ring and conventional manual suture in intestinal anastomosis. Methods 180 patients undergoing intestinal resection with primary anastomosis were divided into a manual suture group (control group)and biofragmenfable anastomosis ring group (BAR group). The anastomoses of 92 cases enrolled in the BAR group was performed with BAR, whereas the other 88 cases in manual suture group were done by standard double layer suture. The restoration time of bowel functions, post-operative complications of anastomotic leaks, bleeding and obstruction were recorded in each group. Results A dead case was recorded in BAR group, but was not related to anastomotic problems. Anastomotic leaks occurred in 1 case in BAR group and 2 cases in manual group. 7 cases incomplete obstruction occured in BAR group and 2 cases in manual suture group respectively(P 0.05=. Post-operative bowel restoration time was 27.2±5.6 h and 49.6±8.7 h respectively,the difference was statistically significant(P 0.01=. The anastomtic inflammatory reaction occured 1 case(2.22%)in BAR group and 11 cases in manual group, the difference was statistically significant(P 0.01=. Conclusion BAR is a safe and effective device in intestinal anastomosis, especially in emergency patients with high-risks. It may be applied as a standard anastomotic method.
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The authors performed anastomoses of small vessels with the Nd-YAG laser, comparing these with conventional suture anastomoses. Some arteries were sutured with 10-0 nylon with about eight suture sites, and others were held by stay sutures at three points with laser irradiation performed between them. Two surgeons performed the anastomoses in the same way. The first was well-trained and experienced, and the second was technically inexperienced. The authors evaluated clamping time, patency rate, and endoscopic and histologic findings. The patency rate of the first surgeon was 100 percent (30/30) in the suture anastomoses and was 97 percent (29/30) in the laser anastomoses. For the second surgeon, the rates were 60 percent (18/30) in the suture group and 80 percent (24/30) in the laser group. On histologic examination, the suture group showed inflammatory cells around the suture site at the fourth week after the operation. In the laser group, an inflammatory reaction around the suture material was observed, but the other areas recovered. For the experienced surgeon, the patency rate and clamping time of the laser anastomosis provided no statistically significant difference to those of the suture anastomosis. On the other hand, for the inexperienced surgeon, the patency rate of the laser anastomosis was superior to that of the suture anastomosis, and the clamping time of the laser anastomosis was shorter than that of the suture anastomosis. Therefore, the authors concluded that the Nd-YAG laser anastomosis is useful for small vessels.
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Abstract Background and Objectives : The argon laser‐assisted vascular anastomosis may solve the problems of conventional sutured anastomosis, such as vascular stenosis and arrest of growth owing to a foreign‐body reaction to suture material. Study Design/Materials and Methods : Twelve argon laser‐assisted vascular anastomoses, seven conventional anastomoses with interrupted sutures, and five conventional anastomoses with continuous sutures were performed in 12 young mongrel dogs. Results : Five months later, the external diameter at the anastomosis had increased 70.5% in the laser group, 67.0% in the interrupted suture group, and 22.9% in the continuous suture group. Histological examination of the laser‐assisted anastomoses showed almost complete healing, with no granulomatous response around the anastomotic site. In the interrupted suture group, marked scaring and foreign body reactions were observed on the vessel wall at the site of the anastomosis. The continuous suture group showed more remarkable disorientation of the vascular layer and intimal hyperplasia than the interrupted suture group. Conclusion : Vascular anastomosis using the argon laser offers advantages over the conventional procedure in growing vessels.
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Colorectal Surgery
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The work is devoted toanew suture in the formation of tracheo-tracheal anastomosis. Despite the improvement of surgical technique in tracheal interventions, the number of postoperative complications (insufficiency and stenosis of anastomosis) remains high, with postoperative lethality reaching 18.2 %. The main problem is the lack of a unified point of view on the choice of the method of anastomosis, in particular, inclusion in the mucosal suture. Several variants of tracheo-tracheal anastomosis are suggested, but a large number of complications testify to the shortcomings of the methods used. The aim of this work is to optimize the imposition of a continuous single-row suture for the formation of tracheo-tracheal anastomosis with a shortening of the trachea. Materials and methods. The study was carried out on the basis of the scientific department of experimental surgery with the vivarium of Irkutsk Scientific Centre of Surgery and Traumatology using Wistar rats, and approved by the ethical committee. Results. A technique for the formation of tracheo-tracheal anastomosis with the use of an original continuous singlerow suture with a shortening of the trachea was developed. Step by step a sequence of operations from access to the cervical trachea to the formation of an anastomosis. Conclusion. The discussed version of the seam in the formation of tracheo-tracheal anastomosis makes it possible to accurately compare and reliably stabilize the sewn ends of the trachea.
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A method for the formation of tracheal and bronchial anastomoses with a two-row suture by means of microsurgical techniques was elaborated in experiments on 52 mongrel dogs. In the control series the bronchial anastomosis was created with interrupted sutures passed through all the coats of the bronchial wall. Morphological study of the reparative processes in the tracheal and bronchial anastomoses showed that healing of the anastomosis formed by means of microsurgical techniques occurred sooner and with a lesser inflammatory reaction than healing of the communication in the control series. This is explained by the fact that the microsurgical suture of the tracheal and bronchial mucosa ensures adequate approximation of the margins of the anastomosis and reliable air-tightness and promotes healing by first intention.
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Objective Toexplore an ideal way of Microvascular anastomosis.Methods Anastomosis of both femoral arteries were performed in 40 rats.Left side of the arteries were anastomsed with medical adhesive.Right side of the arteries as comparise were anastomsed with suture.Biopsy was performed in two groups of rats at different time intervals postoperatively,and the specimens were examined under microscopy(SEM).Results There were no difference in patency between the two techniques.The average anastomotic time for suture was about 18 minuters,while for the adhesive was 12 minuters.SEM of the anastomotic site revealed major differences between sutured and adhered groups.Conclusion Medicl adhesive microvascular anastomosis technique is safe and reliable.
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