• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제37권4호
• /
• pp.312-320
• /
• 2011

A reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. For a better understanding of oral and maxillofacial reconstructive procedures, basic and advanced microvascular anastomosis techniques must be learned and memorized. The aim of this article was to clarify and define the microvascular anastomosis methods, such as primary closure after an arteriotomy, end to side anastomosis, end to end anastomosis, and side to side anastomosis with an artery and vein. This review article discusses the basic skills regarding microvascular anastomoses with brief schematic diagrams in the Korean language. This article is expected to be helpful, particularly to young doctors in the course of the Korean national board curriculum periods for oral and maxillofacial surgery.

• Journal of Yeungnam Medical Science
• /
• 제3권1호
• /
• pp.237-241
• /
• 1986

본 교실에서 백서의 대퇴동맥을 이용하여 혈관감자의 회전없이 continuous suture로 미세혈관 문합을 시행해본 결과 다음과 같은 결론을 얻었다. end-to-end anastomosis시 double c1app의 회전이 어려울 정도로 작업공간이 제한된 경우나 end-to-side anastomosis시 secondary Vessel의 길이가 짧아서 후벽을 잘 볼 수 없는 경우에 continuous suture을 이용하면 Back wall을 완전히 노출시킨 상태에서 쉽게 혈관 문합을 시행할 수 있으며 문합시간도 단축시킬 수 있을 것으로 사료된다.

• Archives of Plastic Surgery
• /
• 제46권4호
• /
• pp.344-349
• /
• 2019

Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.

• Archives of Plastic Surgery
• /
• 제50권5호
• /
• pp.507-513
• /
• 2023

Background Free tissue transfer is considered the gold standard option for the reconstruction of distal leg defects. Free tissue transfer using recipient vessels in the contralateral leg (cross-leg bridge) is a potential option to supply the flap if there are no suitable recipient vessels in the injured leg. Most studies have described this technique using end-to-end anastomosis which sacrifices the main vessel in the uninjured leg. This study evaluated the use of a cross-leg free latissimus dorsi muscle flap for the reconstruction of defects in single-vessel legs, using end-to-side anastomosis to recipient vessels in the contralateral leg without sacrificing any vessel in the uninjured leg. Methods This is a retrospective study that included 22 consecutive patients with soft tissue defects over the lower leg. All the reconstructed legs had a single artery as documented by CT angiography. All patients underwent cross-leg free latissimus dorsi muscle flap using end-to-side anastomosis to the posterior tibial vessels of the contralateral leg. Results The age at surgery ranged from 12 to 31 years and the mean defect size was 86 cm². Complete flap survival occurred in 20 cases (91%). One patient had total flap ischemia. Another patient had distal flap ischemia. Conclusion Cross-leg free latissimus dorsi muscle flap is a reliable and safe technique for the reconstruction and salvage of mutilating leg injuries, especially in cases of leg injuries with a single artery. As far as preservation of the donor limb circulation is concerned, end-to-side anastomosis is a reasonable option as it maintains the continuity of the donor leg vessels.

• 한국정밀공학회지
• /
• 제20권2호
• /
• pp.192-198
• /
• 2003

A finite element analysis of end-to-end artery/PTFE anastomosis has been presented in this study to evaluate the distribution of compliance and stresses in the vicinity of the anastomosis due to any mismatch in compliance characteristics. The artery wall was assumed to be made of linear isotropic material in this simplified model and a nonlinear analysis and convergency study with respect to increasing meshed element numbers were performed with a mean artery pressure loading of the artery-PTFE model. Also, sub-modeling method was Introduced to progress the accuracy of the finite element analysis. The results are as follow : 1. A hypercompliant zone on the artery side was observed around 4.Omm from the anastomosis and a high hoop stresses in the wall of artery and PTFE was dominant. 2. An artery displays large deformation so that nonlinear analysis and sub-modeling method was used. 3. An anastomosis with the thinner thickness and larger diameter PTFE (B type) could reduce the compliance disagreement.

• 대한기계학회:학술대회논문집
• /
• 대한기계학회 2001년도 춘계학술대회논문집A
• /
• pp.877-882
• /
• 2001

A finite element analysis of end-to-end artery/PTFE anastomosis has been presented in this study to evaluate the distribution of compliance and stresses in the vicinity of the anastomosis due to any mismatch in compliance characteristics. The artery wall was assumed to be made of linear isotropic material in this simplified model and a nonlinear analysis and convergency study with respect to increasing meshed element numbers were performed with a mean artery pressure loading of the artery-PTFE model. Also, sub-modeling method was introduced to progress the accuracy of the finite element analysis. The results are as follow : 1. A hypercompliant zone on the artery side was observed around 4.0mm from the anastomosis and a high hoop stresses in the wall of artery and PTFE was dominent. 2. An artery displays large deformation so that nonlinear analysis and sub-modeling method was used. 3. An anastomosis with the thinner thickness and larger diameter PTFE (C type) could reduce the compliance disagreement.

• Journal of Korean Neurosurgical Society
• /
• 제58권5호
• /
• pp.467-470
• /
• 2015

A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.

• 한국임상수의학회지
• /
• 제21권4호
• /
• pp.343-348
• /
• 2004

This study was carried out to investigate the difference between sutured anastomosis and stapler anastomosis (open lumina technique) of jejunum in dogs. Fifteen mongrel-breed female dogs weighting 4 to 6 kgs were allocated to three groups; sutured end-to-end anastomosis (Group I), sutured side-to-side anastomosis (Group II) and stapler anastomosis (Group III), five dogs per each group. All dogs in different anastomosis pattern were compared with time for total operation and suture elapsed for intestines to anastomose, clinical signs, status of feces, complications for 14 days after operation. The total operation time and suture time needed for intestinal anastomosis were significantly(p<0.05) shorter in Group III than Group I and II. All dogs showed no significant difference in vitality, appetite, vomiting between groups for 14 days after operation. All dogs, except one dog in Group II, showed normal vitality and appetite since 7-8 days after operation. Initial return of fecal passage showed in all dogs 8 days after operation and thereafter normal feces were observed in most of the dogs. According to results, all dogs with normal vitality and appetite for 8 days showed good prognosis. In complications after operation, only one dog in Group II showed dehiscence of anastomotic site. There was significant(p<0.05) differences between groups in speed of operation. And all dogs, except one dog in Group II, showed good clinical condition and prognosis. In conclusion, the stapler anastomosis is considered to be more reliable, faster, and precision method compared to the sutured anastomosis for intestinal anastomosis in dogs.

• Journal of Chest Surgery
• /
• 제46권6호
• /
• pp.439-443
• /
• 2013

Background: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. Methods: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. Results: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. Conclusion: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.

• Journal of Chest Surgery
• /
• 제34권10호
• /
• pp.733-744
• /
• 2001

배경: 대동맥 축착증과 심실중격결손이 동반된 환아의 적절한 치료 방침에 대해서는 이견이 많다. 본 연구는 생후 6개월 이하의 환아에서 대동맥 축착증과 심실중격결손의 일타 완전교정 결과 및 수술방법에 따른 대동맥 축착증의 재발에 대해 알아보고자 하였다. 대상 및 방법: 1995년 1월부터 2000년 12월가지 본원에서 대동맥 축착증과 심실중격결손으로 일차 완전교정을 시행받은 생후 6개월 이하의 환아 33명을 대상으로 후향적으로 조사하였다. 환아의 평균 연령과 체중은 각각 54$\pm$37일(12일~171일)과 3.9$\pm$1.1kg(1.5~6kg)이었다. 대동맥 축착 고정은 연구 초기에는 저체온하 완전순환정지하에서 시행하였으며 최근에는 순환정지없이 무명동맥을 통한 국소 뇌관류 상태에서 시행하였다. 축착증 교정 방법은 초기에는 Extended cad-to-end anastomosis(EEEA;n=16)와 Extended side-to-side anastomosis(ESSA;n=2)를, 최근에는 Extended end-to-sidc anasto mosis(EESA;n=15)를 이용하였다 심실중격결손은 초기 16명에서는 Dacron을, 최근 17명에서는 자가 심낭편을 이용하여 폐쇄하였다. 대동맥궁 발육부전은 29명(88%)에서 있었으며 원위부 발육부전 18명, 완전형 5명, 그리고 복잡형은 6명이었다.