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AIM To establish a new improved vascular anastomotic technique to simplify the surgical technique and increase the survivsl rate of small intestinal transplantation in rats.METHODS The graft removed en bloc consisted of entire small intestine, portal vein and aortic segment with superior mesenteric artery. The graft was perfused in situ and the gut lumen was irrigated during the operation.Heterotopic small bowel transplantation was performed by microvascular end-to-side anastomosis between the donor aortic segment with superior mesenteric artery and the recipient abdominal aorta, and by the formation of a "Cuff" anastomosis between the donor portal vein and the recipient left renal vein. Both ends of the grafts were exteriorized as stomas. RESULTS A total of 189 intestinal transplantations were performed in rats, 33 of which were involved in the formal experimental group, with a survival rate of 84.8%. The average time for the donor surgery was 80min ±10min; for graft repair 10min ± 3min; and for recipient surgery 95min ± 15min. The average time for the arterial anastomosis and the vein anastomosis was 18min ± 5min and imin,respectively. The warm ischemic time and cold ischemic time were 22min ± 5min and less than 60min, respectively. The whole operation was completed by a single surgeon, the operative time being about 3 hours. CONCLUSION The vascular anastomosis used in this study could simplify surgical technique,reduce the operative time and elevate the survival rate of small intestinal transplantation in rats.
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游离皮瓣在小儿手外伤中的应用
本文报告1986年以来作者应用吻合血管的游离皮瓣修复小儿手部软组织缺损7例.年龄3~13岁,皮瓣面积为(6×7)~(12×6)cm.术后经过顺利,没有发生伤口感染和血管危象,皮瓣全部成活,疗效满意.讨论了吻合血管的手术指征和时机.
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小儿肾血管性高血压的外科治疗(包括6例自体肾移植术)
近十余年来,对肾血管性高血压的外科治疗有较大的进展,国内外文献报导亦渐见增多,但有关小儿病例的报告尚少.我院自1976~1981年间共收治9例,均作了腹主动脉、肾动脉造影术,诊断明确.本文重点介绍与讨论自体肾移植术的疗效与评价.