Three end-to-end techniques for microvascular anastomosis of vessels with different size discrepancy
Retrospective study published in Ann Plast Surg (2020)
Abstract
BACKGROUND: Size discrepancy in microvascular anastomosis is a common issue in free flap transfer and replantation surgery. A number of different techniques have been described to overcome the problem, but optimal method continues to be defined. METHODS: Since June 2015 to May 2018, clinical courses of 103 microvascular cases performed by one senior surgeon were reviewed. Three end-to-end techniques including mechanical dilation, single-mattress suture, and wedge resection were applied in 364 anastomoses with caliber ratio between 1:1 and 1:1.5, 1:1.5 and 1:2, and 1:2 and 1: 3, respectively. RESULTS: A total of 112 flaps were incorporated in this study. The incidence of anastomotic failure was 3.0% (11/364), and the overall flap failure rate was 3.6% (4/112). The failure cases included 2 replanted scalps, 1 replanted ear, and 1 superficial temporal artery flap for nasal reconstruction. CONCLUSIONS: Our results depicted operational convenience and reliability of the 3 end-to-end anastomotic techniques in addressing mild-to-large vessel discrepancy.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Series of 364 anastomoses using mechanical dilation, single-mattress suture, or wedge resection for varying caliber ratios. 3.0% anastomotic failure, 3.6% flap failure rates across 112 flaps.
Por qué esto importa para la hirudoterapia
Este estudio revisó 103 casos microvasculares (112 colgajos, 364 anastomosis) realizados por un único cirujano senior, comparando tres técnicas de anastomosis término-terminal (dilatación mecánica, sutura de colchonero simple, resección en cuña) para abordar la discrepancia de calibre vascular en la transferencia de colgajos libres y reimplantes. La falla anastomótica global fue del 3,0 % y la falla del colgajo del 3,6 %. La relevancia para el ámbito de la ASH es indirecta: el trabajo aborda aspectos técnicos de la cirugía microvascular en el contexto en el que las sanguijuelas medicinales se utilizan a veces para la congestión venosa posoperatoria, pero no se mencionan las sanguijuelas. No se aportan datos sobre hirudoterapia, el secretoma ni el manejo de la congestión venosa. El estudio se limita a los desenlaces de la técnica quirúrgica obtenidos de la experiencia de un solo cirujano.
Citación
Three end-to-end techniques for microvascular anastomosis of vessels with different size discrepancy.
Zhang Y et al. · Annals of plastic surgery, 2020
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026