The Continuous-interrupted Method For Arterial Anastomosis In Organ Transplantation

Organ transplantation is an effective therapeutic method for organ failure,which has been widely used in clinical applications.The vascular anastomosis is the key of the surgical operation,and it determines the successful rates in operation.Nowadays there are many arterial anastomosis methods,such as: suture method,cuff anastomosis,blood vessel anastomosis method and so on.However,the suture method is still commonly used in the clinical blood vessel anastomosis.The vascular suture method mainly include in two kinds method: continuous suture method;interrupted suture method.According to different vascular anastomotic situation: the blood vessel diameter,blood pressure,anastomotic type(end-to-end anastomosis,end-to-side anastomosis,side-to-side anastomosis),will lead to different result of anastomosis.End-to-side anastomosis in small arteries was difficult to achieve,because of it has small vessel diameter,arterial adventitia often affected anastomosis and anastomosis site always could not keep match well during the operation.The ideal surgical operation,on the one hand we need the advantage of continuous suture to reduce the operation time,on the other hand we need the advantage of interrupted suture to reduce the surgical complications.Continuous-interrupted suture method both have the advantages of continuous suture and interrupted suture,and it can overcome the limitations of the two methods,which a new suture method for arterial anastomosis.In this study,we used the mouse heart transplantation model to evaluate the feasibility of Continuous-interrupted methodfor arterial anastomosis.The first part of this study,we used the rejection model in mouse heart transplantation(C57BL / 6 j-BALB/c)for arterial anastomosis using continuousinterrupted suture method.As a result,we found that method for arterial anastomosis with a high successful rate(90%).The graft median survival time and myocardial H.E.results show that the method could not affect the acute rejection.The research show that the continuous-interrupted suture method was the better way for small arterial anastomosis.Follow-up experiments,we choose the syngeneic transplantation model to eliminate the interference rejection.We used continuous-interrupted suture method for arterial anastomosis in this model(BALB/c-BALB/c)to compare with continuous suture and continuous-interrupted suture method in operation time,operation successful rate,complications.We found that in continuous-interrupted suture group the operation successful rates and the risk of complications was better than the continuous suture group.In anastomosis site pathological histology and scanning electron microscopy observation to prove that continuous-interrupted method was better than the continuous method in rebuilt of the anastomotic endothelial.To sum up,the continuous-interrupted suture method is a kind of new method for small vascular anastomosis.This method not only can be used for clinical organ transplant surgery,but also can be used in the orthopaedic reattachment,arteriovenous fistula and so on.With the development of vascular anastomosis,different suture method gave us many different choices to clinical application.Continuous-interrupted suture method provides us a good idea for small vascular anastomosis.Objective: Alpha fetoprotein-producing gastric cancer(AFPGC),as a special kind of gastric carcinoma with high AFP in serum.This type of gastric cancer patients has low proportion of all patients with gastric cancer,less than 15%.However,the characteristics and type of AFPGC is not fully clear.In this study,we used retrospective analysis to compare of two kinds of gastric carcinoma.The data was collected from the First Affiliated Hospital of Dalian Medical University,during January 2003 and December 2011.Methods: According to the data(The First Affiliated Hospital of Dalian Medical University General Surgery),we divide two groups for analysis in AFP volume in serum.At the same time exclude AFP related diseases(such as: primary liver cancer,embryonal tumors,etc.).In AFP(+)group we collected 50 patients,other group for 498 patients in control.Then we divide the two group in the size of the serum AFP value into high value groups(AFP ?11.6?g/L,a total of 23 cases)and low value groups(AFP< 11.6?g/L,a total of 27 cases).Data was analyzed by SPSS23.0(IBM,USA)software,through independent student's t-test,Kaplan-Meier survival curve analysis methods and(P < 0.05)for the significant difference.Results: Through the analysis of the data,we found that the AFP tumor characteristics of patients with AFP gastric cancer and normal gastric cancer,including tumor size,tumor pathological types and tumor metastasis have no significant difference between the two groups.However,the AFPGC patients always appear liver metastasis and vascular invasion.There was significant difference between the two groups(P < 0.05).In liver metastasis,the size of AFP has statistically relation between the two groups(P < 0.05).For survival,AFPGC survival time is shorter than ordinary patients with gastric cancer,and has no significant relation with the AFP size in serum.Conclusions: There was no significant difference between the AFPGC patients and normal gastric cancer stomach patients in tumor features.However,the two groups have significant difference in liver metastasis and vascular invasion.For survival time,AFPGC survival time shorter than the normal gastric cancer and the size of AFP in Serum has no significant difference between two groups.