Improvement of microsurgical techniques in orthotopic rat liver transplantation.

Autor: Ariyakhagorn V; Department of Surgery, Chiangmai University, Chiangmai, Thailand. veeravorn.ariyakhagorn@charite.de, Schmitz V, Olschewski P, Polenz D, Boas-Knoop S, Neumann U, Puhl G
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2009 May 15; Vol. 153 (2), pp. 332-9. Date of Electronic Publication: 2008 May 05.
DOI: 10.1016/j.jss.2008.04.003
Abstrakt: Background: Because of the limited tolerance to portal venous clamping, the model of liver transplantation in rats represents a difficult task, which requires a great proportion of experience. Since techniques that include the introduction of an artificial stent increase the risk of thrombosis, it was our goal to modify the classical vascular hand-sewn venous anastomosis technique by using a modified end-to-end knotless procedure.
Materials and Methods: Seventy-two animals were randomly assigned to 1 of 2 experimental groups, which differed by the technique for the 3 venous anastomoses (supra- and infrahepatic vena cava, portal vein). Group 1 comprised the established suturing technique for rat liver transplantation, whereas all venous anastomosis of the second group were performed using our modified technique.
Results: With our method, average anhepatic time could be significantly reduced from 14 min 10 s (+/-100 s) to 11 min 40 s (+/-60 s) (P < 0.001). Kaplan-Meier survival rates demonstrated a better 7-d survival for the knotless (94%) compared to the classic technique (83%) (not significant, P = 0.137). Biliary complications were low in both groups but tended to be higher in the classical group.
Conclusions: Our modified knotless anastomosis proves to be equally safe in regard to complications, improves timing, and provides excellent results in the model of orthotopic rat liver transplantation.
Databáze: MEDLINE
Externí odkaz: