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Littérature scientifique sur le sujet « Anastomosi »

Auteur : Grafiati

Publié le 1 avril 2023

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Articles de revues sur le sujet "Anastomosi"

Selli, C., M. Carini et A. Costantini. « Le Anastomosi Uretero-Caliciali ». Urologia Journal 52, n^o 2 (avril 1985) : 168–74. http://dx.doi.org/10.1177/039156038505200205.

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Lechaux, J. P., et D. Lechaux. « Anastomosi biliodigestive nella litiasi biliare ». EMC - Tecniche Chirurgiche Addominale 14, n^o 1 (janvier 2008) : 1–9. http://dx.doi.org/10.1016/s1283-0798(08)70473-x.

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SHIMA, Takeshi, Yoshikazu OKADA, Shigejiro MATSUMURA, Masahiro NISHIDA, Tohru YAMADA, Takashi HATAYAMA et Shinji OKITA. « Cortical Arterial Pressure and Anastomotic Blood Flow Measurements during STA-MCA Anastomosi ». Neurologia medico-chirurgica 28, n^o 4 (1988) : 340–45. http://dx.doi.org/10.2176/nmc.28.340.

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Franch, L., A. Rippa, P. M. Ferri et I. Vavassori. « Anastomosi Cervico-Uretrale Dopo Adenomectomia Prostatica Retropubica ». Urologia Journal 54, n^o 3 (juin 1987) : 345–49. http://dx.doi.org/10.1177/039156038705400318.

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Walker, Patrick F., Joseph D. Bozzay, David W. Schechtman, Faraz Shaikh, Laveta Stewart, M. Leigh Carson, David R. Tribble, Carlos J. Rodriguez et Matthew J. Bradley. « Anastomotic Outcomes in Military Exploratory Laparotomies in the Modern Combat Era ». American Surgeon 88, n^o 4 (13 janvier 2022) : 710–15. http://dx.doi.org/10.1177/00031348211050281.

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Background Intestinal anastomoses in military settings are performed in severely injured patients who often undergo damage control laparotomy in austere environments. We describe anastomotic outcomes of patients from recent wars. Methods Military personnel with combat-related intra-abdominal injuries (June 2009-December 2014) requiring laparotomy with resection and anastomosis were analyzed. Patients were evacuated from Iraq or Afghanistan to Landstuhl Regional Medical Center (Germany) before being transferred to participating U.S. military hospitals. Results Among 341 patients who underwent 1053 laparotomies, 87 (25.5%) required ≥1 anastomosis. Stapled anastomosis only was performed in 57.5% of patients, while hand-sewn only was performed in 14.9%, and 9.2% had both stapled and hand-sewn techniques (type unknown for 18.4%). Anastomotic failure occurred in 15% of patients. Those with anastomotic failure required more anastomoses (median 2 anastomoses, interquartile range [IQR] 1-3 vs. 1 anastomosis, IQR 1-2, P = .03) and more total laparotomies (median 5 laparotomies, IQR 3-12 vs. 3, IQR 2-4, P = .01). There were no leaks in patients that had only hand-sewn anastomoses, though a significant difference was not seen with those who had stapled anastomoses. While there was an increasing trend regarding surgical site infections (SSIs) with anastomotic failure after excluding superficial SSIs, it was not significant. There was no difference in mortality. Discussion Military trauma patients have a similar anastomotic failure rate to civilian trauma patients. Patients with anastomotic failure were more likely to have had more anastomoses and more total laparotomies. No definitive conclusions can be drawn about anastomotic outcome differences between hand-sewn and stapled techniques.

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Ujihira, Kosuke, et Akira Yamada. « Novel Dry-Lab Training Method for Totally Endoscopic Coronary Anastomosis ». Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery 12, n^o 5 (septembre 2017) : 363–69. http://dx.doi.org/10.1097/imi.0000000000000406.

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Objective We describe our original dry-lab training system for nonrobotic and beating heart endoscopic coronary artery anastomosis. Methods All the materials used for this training were commercially available. We selected a boxed machine, which can produce pulsatile movements of artificial vessels, and on its roof, we installed a two-dimensional home video camera and a monitor. A multiple-holed plate was placed in front of the machine, and through these holes, a trainee inserted endoscopic surgical instruments and anastomosed the artificial vessels by running fashion while watching the monitor. This training program has four stages. During the first stage, a trainee has to demonstrate mastery in conducting a conventional off-pump coronary artery anastomosis without assistance. The second stage is the “nonbeating” version, and the third stage is the “beating” version with the model mentioned previously. After a trainee gets accustomed to the third stage, the original artificial vessel is replaced with an extremely fragile one, and this is the fourth stage. Our trainee conducted one hundred fourth-stage anastomoses and each procedure was recorded with the video camera. We analyzed several factors from the videos and evaluated the efficacy of the training method. We compared the outcomes of the first 50 consecutive anastomoses with the following 50 ones and described the learning curves. Results The comparison showed a significant decrease in anastomotic time and vessel injury. We considered the quality of anastomosis acceptable after 47 anastomoses, and anastomotic time fell below 15 minutes at the 81st training at the fourth stage. Conclusions Our dry-lab system might be an effective training method for endoscopic coronary anastomosis.

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Gerdisch, Marc, Thomas Hinkamp et Stephen D. Ainsworth. « Blood Flow Pattern and Anastomotic Compliance for Interrupted versus Continuous Coronary Bypass Grafts ». Heart Surgery Forum 6, n^o 2 (2 février 2005) : 65. http://dx.doi.org/10.1532/hsf.740.

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Background: Use of the interrupted coronary anastomosis has largely been abandoned in favor of the more rapid continuous suturing technique. The Coalescent U-CLIP anastomotic device allows the surgeon to create an interrupted distal anastomosis in the same amount of time that it would take to create a continuous anastomosis. This acute bovine study examined the effect of the anastomotic technique on blood flow and vessel wall function. Methods: End-to-side coronary anastomoses were created in an open chest bovine model using the left and right internal thoracic arteries and the left anterior descending coronary artery. All other variables except suturing technique were carefully controlled. In each animal, one anastomosis was completed using a continuous suturing technique and the other was performed in an interrupted fashion using the Coalescent U-CLIP anastomotic device. Volumetric flow curves through each graft were analyzed using key indicators of anastomotic quality, and anastomotic compliance was evaluated using intravascular ultrasound. Luminal castings were created of each vessel to examine the interior surface of each anastomosis for constrictions and deformities. Results: The interrupted anastomoses created with the Coalescent U-CLIP anastomotic device showed significant differences with respect to anastomotic compliance, pulsatility index, peak flow, and percentage of diastolic flow. The cross-sectional area and degree of luminal deformity were also different for the two suturing techniques. Conclusions: In this acute bovine model, interrupted coronary anastomoses demonstrated superior geometric consistency and greater physiologic compliance than did continuously sutured anastomoses. The interrupted anastomosis also caused fewer disturbances to the flow waveform, behaving similarly to a normal vessel wall. The combination of these effects may influence both acute and long-term patency of the coronary bypass grafts.

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Khajanchee, Yashodhan S., W. Cory Johnston, Maria A. Cassera, Paul D. Hansen et Chet W. Hammill. « Characterization of Pancreaticojejunal Anastomotic Healing in a Porcine Survival Model ». Surgical Innovation 24, n^o 1 (28 octobre 2016) : 15–22. http://dx.doi.org/10.1177/1553350616674638.

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Introduction: Anastomotic leak after pancreaticoduodenectomy is the most important cause of postoperative morbidity and mortality. Histological studies of bowel anastomoses have provided valuable insights regarding causes of anastomotic failure. However, this crucial information is lacking for pancreatico-enteric anastomoses. Methods: Pancreaticoduodenectomy was performed in a porcine model. Animals were survived up to 10 days and then the pancreatico-enteral anastomosis specimen was resected en bloc. Anastomotic bursting pressure was measured and histological sections of the anastomoses were examined. Results: Six out of 8 animals had excellent healing of the anastomoses. One animal developed a clinically significant leak at the pancreaticoduodenal anastomosis (12.5%) and one animal had a subclinical duodeno-duodenal leak discovered on necropsy (12.5%). Both anastomoses that failed had a collagen-to-tissue ratio less than 40%. In contrast, none of the anastomoses with a ratio greater than 40% showed any evidence of disruption. Conclusion: Our results indicate that quantitative measurement of collagen deposition at the pancreatic anastomosis provides objective assessment of healing of the pancreatic anastomosis. A survival porcine model of pancreaticoduodenectomy results in a similar leak rate to published data on pancreaticoduodenectomy in humans and will be useful for future studies assessing novel pharmacologic or technical interventions aimed at improving outcomes.

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Herr, Leonard J. « Relationship of binucleate Rhizoctonia isolates used for biocontrol of rhizoctonia crown rot of sugar beet to anastomosis systems ». Canadian Journal of Microbiology 37, n^o 5 (1 mai 1991) : 339–44. http://dx.doi.org/10.1139/m91-055.

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The relationships of 10 binucleate Rhizoctonia isolates used as biocontrol agents of rhizoctonia crown and root rot of sugar beet in Ohio to described binucleate Rhizoctonia anastomosis systems were investigated. Ten Ohio binucleate Rhizoctonia (Ohio BNR) isolates, paired in all combinations, cross anastomosed with one another, indicating that all belong to the same anastomosis group. Four representative Ohio BNR isolates failed to anastomose with any tester isolates of the Ceratobasidium anastomosis grouping system, indicating that none belong in that system. However, all 10 Ohio BNR isolates anastomosed with an AG-B (o) tester isolate (binucleate Rhizoctonia anastomosis grouping system), indicating that the Ohio agents belong in this anastomosis grouping system and to the (o) intraspecific group of AG-B. None of the Ohio BNR isolates anastomosed with either of the other two intraspecific group tester isolates (AG-Ba, AG-Bb) of the AG-B group. Moreover, the AG-B intraspecific group tester isolates, AG-Ba, AG-Bb, AG-B (o), self-anastomosed but did not cross anastomose with one another. Variations in cultural characteristics noted among the 10 Ohio BNR isolates indicated that considerable heterogeneity exists within these AG-B (o) isolates. Key words: binucleate Rhizoctonia, anastomosis, rhizoctonia crown rot, sugar beet.

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Vilhjalmsson, Dadi, Per Olofsson, Ingvar Syk, Henrik Thorlacius et Anders Grönberg. « The Compression Anastomotic Ring-Locking Procedure : A Novel Technique for Creating a Sutureless Colonic Anastomosis ». European Surgical Research 54, n^o 3-4 (16 décembre 2014) : 139–47. http://dx.doi.org/10.1159/000368354.

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Background/Aim: Compression anastomoses might represent an improvement over traditional hand-sewn or stapled techniques. Herein, we describe a novel concept of sutureless colonic anastomosis named compression anastomotic ring-locking procedure (CARP). Materials and Methods: The surgical device consists of two anastomotic rings and their associated helping tools, facilitating the placement of the rings into the intestinal ends. Furthermore, four catheters are connected to the surgical device, allowing the evaluation of the anastomosis during and after surgery. A total of 31 pigs underwent a low colocolic anastomosis using the anastomotic rings. The compression pressure was measured perioperatively and up to 96 h after surgery. Anastomotic integrity and morphology were analyzed by use of radiology and histology, respectively. A long-term follow-up was conducted in a subgroup of pigs up to 108 days after surgery when the bursting pressure and stricture formation were examined. Results: All animals recovered uneventfully, and macroscopic examination revealed intact anastomoses without signs of pathological inflammation or adhesions. The perioperative compression pressure was inversely proportional to the gap size between the anastomotic rings. For example, an anastomotic gap of 1.5 mm created a colonic anastomosis with a perioperative compression pressure of 91 mbar, which remained constant for up to 48 h and resulted in a markedly increased compression pressure. Contrast infusion via the catheters effectively visualized the anastomoses, and no leakage was detected within the study. The surgical device was spontaneously evacuated from the intestines within 6 days after surgery. Histology showed collagen bridging of the anastomoses already 72 h after surgery. Long-term follow-up (54-108 days) revealed no stricture formation in the anastomoses, and the bursting pressure ranged from 120 to 235 mbar. The majority of bursts (10/12) occurred distant from the anastomoses. Conclusion: We conclude that the surgical device associated to CARP is safe and efficient for creating colonic anastomoses. Further studies in patients undergoing colorectal surgery are warranted.

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Thèses sur le sujet "Anastomosi"

CARDINALI, LUCA. « Emicolectomia destra robotica con anastomosi intracorporea versus laparoscopica con anastomosi extracorporea ». Doctoral thesis, Università Politecnica delle Marche, 2018. http://hdl.handle.net/11566/259705.

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Scopo: La chirurgia robotica ha lo scopo di migliorare i risultati chirurgici superando i limiti intrinseci della laparoscopia convenzionale, semplificando le procedure più complesse come il confezionamento intracorporeo dell’anastomosi. Diversi studi suggeriscono che la realizzazione dell’anastomosi intracorporea dopo una colectomia destra possa offrire diversi vantaggi. Gli autori riportano uno studio retrospettivo nel quale vengono confrontati i risultati della colectomia destra robotica con anastomosi intracorporea (RRC-IA) rispetto a quella laparoscopica con anastomosi extracorporea (LRC-EA). Metodi: Una revisione retrospettiva del database prospetticamente mantenuto nella nostra istituzione è stata eseguita estrapolando i dati relativi ai pazienti sottoposti a RRC-IA e LRC-EA per malattia di Crohn, adenoma o neoplasia nel periodo compreso tra Settembre 2013 ed Agosto 2017. Centosessantotto pazienti (RRC-IA = 70, LRC-EA = 98) hanno soddisfatto i criteri di inclusione per l'ammissibilità nello studio. Sono stati valutati i risultati perioperatori e postoperatori a breve termine riportati nei due gruppi di studio. Risultati: Il gruppo RRC-IA, a fronte di un tempo operatorio superiore, ha mostrato una più breve ripresa della funzione alvica e dell’alimentazione. Non sono state riscontrate differenze significative nella durata della degenza ospedaliera, morbilità a 30 giorni, mortalità e numero di linfonodi asportati. Conclusione: La RRC-IA sembra offrire lievi vantaggi rispetto alla LRC-EA in termini di risultati postoperatori, anche se necessita di maggiori tempi operatori e costi. Una maggiore esperienza con la tecnica robotica potrebbe consentire a questi vantaggi clinici di bilanciare alcune delle preoccupazioni legate agli elevati costi che hanno scoraggiato la diffusione della tecnologia robotica per l’esecuzione della colectomia.
Aim: Robotic surgery is intended to improve surgical outcomes overcoming the inherent limitations of conventional laparoscopy by simplifying the most complex procedures such as the intracorporeal fashioning of an anastomosis. Several studies suggest that the intracorporeal confectioning of an anastomosis after a laparoscopic right colectomy may offer several advantages. The authors report a retrospective study comparing robotic right colectomy with intracorporeal anastomosis (RRC-IA) versus laparoscopic right colectomy with extracorporeal anastomosis (LRC-EA) Methods: A retrospective review of a prospectively maintained database of our institution was performed on the data on patients undergoing RRC-IA or LRC-EA for Crohn’s disease, adenomas or cancer between September 2013 and August 2017. One hundred and sixty-eight patients (RRC-IA=70, LRC-EA=98) met the inclusion criteria for eligibility in the study. Perioperative and short-term outcomes have been assessed. Results: A statistically significant difference was found between the two groups in terms of mean operative time and postoperative outcomes. Compared with the LRC-EA, the RRC-IA required a longer operative time but had better postoperative outcomes, such as a shorter time to first flatus and oral feeding recovery. No significant differences were found in the length of hospital stay, 30-day morbidity, mortality and number of lymph nodes harvested. Conclusion: The RRC-IA seems to offer slight advantages over LRC-EA in term of postoperative outcomes even if it still requests increased operative time and costs. Greater experience with the robotic technique may allow these advantages to counter some of the cost-related concerns that have deterred the more widespread utilization of robotic technology for colectomy.

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CAPPELLETTI-TROMBETTONI, MARIA-MICHELA. « FANS ed anastomosi intestinale in un modello sperimentale di peritonite ». Doctoral thesis, Università Politecnica delle Marche, 2016. http://hdl.handle.net/11566/243148.

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FANS ed anastomosi intestinale in un modello sperimentale di peritonite Scopo dello Studio. In questo studio ci proponiamo di valutare l’effetto del Diclofenac e del Ketorolac sulla guarigione di anastomosi colo-coliche a rischio di deiscenza perchè confezionate in condizione di peritonite. Materiali e Metodi. Sedici ratti Wistar sono stati sottoposti alla medesima procedura di induzione della peritonite tramite legatura e puntura del cieco e, il giorno seguente, a confezionamento di anastomosi colo-colica sul colon discendente. Tutti i ratti sono stati inoltre sottoposti a terapia medica antibiotica (Imipenem) ed antidolorifica (Dolorex). Gli animali sono stati casualmente assegnati a 3 diversi gruppi. Ai ratti del gruppo C (controllo) non sono stati somministrati ulteriori farmaci. Ai 6 ratti del gruppo K (Ketorolac) e ai 6 ratti del gruppo D (Diclofenac) è stato somministrata terapia sottocutanea giornaliera con FANS dal momento del confezionamento dell’anastomosi per ulteriori 4 giorni. Gli animali sono stati sacrificati a sette giorni per la valutare l’aspetto macroscopico dell’anastomosi, il microcircolo, la bursting pressure, i paramentri di guarigione istologica e l’espressione del VEGF con tecnica immunoistochimica. Risultati. Non ci sono state variazioni statisticamente significative dei parametri studiati fra I gruppi trattati con FANS ed il gruppo di controllo. Anzi, nei gruppi K e D è evidente precoce riepitelizzazione mucosa, invece assente nel gruppo C. Conclusioni. I risultati preliminari di questo studio dimostrano che la somministrazione di FANS non altera la guarigione delle anastomosi coliche in condizioni di peritonite.
Effects of FANS on colon anastomosis repair in a rat model of peritonitis Background. In this study we aimed to investigate the effects of Diclofenac and Ketorolac on the healing of colonic anastomoses in the presence of polymicrobial sepsis. Materials and Methods. Sixteen Wistar rats were divided into 3 groups. Cecal ligation and puncture were performed for peritonitis. On the day after, an anastomosis of the left colon was performed and all rats received antibiotic (Imipenem) and analgesic therapy (Dolorex). In group C (control group) no other therapies were administered. In group K, 6 rats received 5 mg/kg of Ketorolac. In group D, 6 rats received 4 mg/Kg of Diclofenac. The drugs were administred subcutaneously at costruction of colonic anastomosis and were repeated (every 24 hours) for 4 day at the same dose. On postoperative day 7, all animals were killed and anastomotic macroscopic appearence, bursting pressures and microcirculation were measured. Tissue samples were obtained for further investigation of histological parameters and immunohistochemistry for VEGF. Results. There were no significative differences, for all variables measured, among the groups, in particular FANS groups provided greater mucosal re-epitheliazation compared to control group. Conclusion. This study showed that the administration of FANS dosen’t affect anastomotic colonic healing in rats peritonitis.

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Gurrado, Angela. « L'impiego di patch di pericardio bovino nelle anastomosi intestinali. Studio sperimentale sul maiale ». Doctoral thesis, Università di Catania, 2012. http://hdl.handle.net/10761/1144.

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Introduzione: La deiscenza dell anastomosi ha un incidenza tra il 2% e il 10%, con aumento della morbilità (20-30%) e della mortalità (7-12%). Scopo dello studio è verificare gli effetti di una benderella di materiale protesico biologico di pericardio bovino apposta in vivo sulla rima di sutura di anastomosi intestinali e se la stessa eviti la comparsa di filtrazione anastomotica. Materiale e Metodo: Sono stati adoperati 95 maiali domestici divisi in 4 gruppi: gruppo 1 (30 animali): l anastomosi ileo-ileale e colo-colica in singolo strato con punti staccati di PDS 3/0 secondo Gambee; gruppo 2 (30): anastomosi con apposizione di benderella biologica di pericardio bovino; gruppo 3 (5): uno dei punti di PDS 3/0 secondo Gambee del singolo strato delle anastomosi veniva deliberatamente saltato; gruppo 4 (30): uno dei punti di PDS 3/0 secondo Gambee del singolo strato delle anastomosi veniva deliberatamente saltato con apposizione della benderella di pericardio bovino. Sono state condotte valutazioni intraoperatorie, analisi istopatologiche, biochimiche, di tensiometria e di elettrofisiologia sui segmenti intestinali prelevati sui segmenti intestinali prelevati a 48, 96h, 7, 14, 30 e 90 gg. Risultati: a tutti i livelli di analisi effettuate è evidenziabile un miglioramento del processo di guarigione delle stesse. Conclusioni: l utilizzo della benderella di pericardio bovino a rivestimento delle anastomosi intestinali rappresenta una metodica sicura. Inedito è il rilievo istopatologico dell arresto dello spandimento del contenuto intestinale in cavità addominale nei casi di perforazione iatrogena ileale e colica a carico delle anastomosi rivestite da pericardio bovino, con conseguente prevenzione della peritonite acuta.

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Trombatore, Claudia. « Tomografia computerizzara e rischio di deiscenza delle anastomosi chirurgiche del colon : abdominal calcium score-nostra esperienza ». Doctoral thesis, Università di Catania, 2018. http://hdl.handle.net/10761/4155.

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La deiscenza dell anastomosi chirurgica rappresenta la più temuta e la più severa complicanza in chirurgia colon-rettale. I processi che determinano l insorgenza della deiscenza anastomotica sono complessi e attualmente solo parzialmente conosciuti. L aterosclerosi potrebbe essere un fattore implicato nel processo di deiscenza, in quanto spia di un alterazione del microcircolo della parete colica che interferisce con i fisiologici processi di riparazione tissutale a livello delle anastomosi. La stima dell aterosclerosi dell aorta addominale può essere effettuata con TC attraverso il calcolo dell AAC secondo il metodo Agatston. I nostri risultati dimostrano una differenza statisticamente significativa dei valori di calcium score tra due gruppi di pazienti "deiscenza" e "no-deiscenza". In conclusione il calcium score può essere considerato in fase pre-operatoria un fattore di predizione del rischio di deiscenza.

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Pereira, Yara Emantne Amaral. « Influencia do choque hemorragico na anastomose de colon sigmoide em ratos : avaliação com teste de resistencia a pressão de ruptura ». [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308756.

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Orientadores: Claudio Saddy Rodrigues Coy, João Jose Fagundes
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-09T01:10:44Z (GMT). No. of bitstreams: 1 Pereira_YaraEmantneAmaral_M.pdf: 1682869 bytes, checksum: 9d5801f67ab43156ce97cd3a10778b4d (MD5) Previous issue date: 2007
Resumo: Introdução: As complicações das anastomoses intestinais podem ser graves com altos índices de morbi/mortalidade. Vários fatores relacionados à qualidade das mesmas têm sido objetos de estudos, como técnica operatória, fios de sutura ou variáveis bioquímicas, enquanto que outros, não associados diretamente à técnica cirúrgica, são menos avaliados, como por exemplo, a influência de choque hemorrágico. Objetivo: Avaliar o efeito do choque hemorrágico em anastomoses de cólon em ratos, com teste de ruptura à distensão por líquido. Material e Método: Foram utilizados ratos da linhagem Wistar, com idade aproximada de 90 dias e peso variando de 310 gramas a 380 gramas. Os animais foram divididos em dois grupos, sendo o grupo G1, composto por 10 animais submetidos à anastomose de cólon em condições de normovolemia e o grupo G2, composto por 10 animais submetidos à anastomose de cólon em condições de hipovolemia. O choque foi instalado através da retirada de meio mililitro de sangue a cada dois minutos, até que se atingissem valores de pressão arterial média (PAM) de 50mmHg ou volume total de retirada correspondente a 30% da volemia. Foram realizadas dosagens séricas de lactato (mmol/l) no início do procedimento e ao término do mesmo. Os valores séricos médios de lactato ao término da cirurgia foram de 1,91 mMol/l no grupo G1 e de 3,69 mMol/l no grupo G2 (p<0,05) No quinto dia de pós-operatório, os animais foram submetidos à eutanásia e tiveram suas anastomoses testadas por teste de resistência à pressão de ruptura à distensão por líquido. Resultados: No grupo G1, o valor médio da pressão de ruptura do cólon à distensão por líquido foi de 160,7 mmHg enquanto que no grupo G2 foi de 152,1mmHg (p>0,05). Conclusão: A presença de choque hemorrágico, nas condições estabelecidas neste estudo, não exerceu influência em anastomoses de cólon em ratos, avaliadas com teste de ruptura à distensão por líquido
Abstract: Introduction: Intestinal anastomoses complications can be very serious, with high morbidity and mortality rates. Several factors related to their quality have been object of studies, such as technical aspects, suture threads or biochemical variables. Others, not directly associated with the surgery technique, are less evaluated, such as the influence of hemorrhagic shock. Objective: Evaluate the effect of hemorrhagic shock in colonic anastomoses in rats, with resistance test to rupture by liquid distension. Methods and Material: Wistar lineage rats, averaging 90 days old and weight varying from 310 to 380 grams were divided into two groups. In the G1 group, 10 animals were submitted to colonic anastomoses in normovolemic terms and the G2 group 10 animals were submitted to colonic anastomoses in hipovolemic conditions. The shock was caused by half milliliter blood withdrawal, done every two minutes, until reached the value of average arterial pressure of 50mmHg or total volume of corresponding withdrawal to 30% of volemia. Serum lactate dosages were carried out at the beginning and at the end of the procedure. The average serum values lactate at the end of the surgery were 1,91 mMol/l in the G1 group and 3,69 mMol/l in the G2 group (p<0,05). On the fifth postoperative day, the animals were submitted to euthanasia. The anastomoses were evaluated with resistance test to rupture by liquid distension. Results: In the G1 group, the average value of colonic rupture was 160,7mmHg whereas in the G2 group was 152,1mmHg (p>0,05). Conclusion: Hemorrhagic shock, in the established conditions of this study, had no influence in colonic anastomosis in rats evaluated with resistance test to rupture by liquid distention
Mestrado
Cirurgia
Mestre em Cirurgia

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Oppido, Guido <1971&gt. « Analisi dei fattori che influenzano la crescita delle arterie polmonari nei pazienti con cuore funzionalmente univentricolare sottoposti ad anastomosi cavo-polmonare bidirezionale ». Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/7157/1/oppido_guido_tesi.pdf.

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La BCPA e’ ormai utilizzata routinariamente come stadio intermedio della palliazione di Fontan nel trattamento dei cuori funzionalmente univentricolari e si conferma intervento a ridotta mortalità e morbilità. La crescita delle arterie polmonari dopo BCPA è abbastanza variabile ed imprevedibile, le dimensioni indicizzate dei rami principali sembrano tendenzialmente ridotte, tranne quelle dell’arteria lobare inferiore destra, la quale beneficerebbe del flusso preferenziale della BCPA. Proprio i pazienti con arterie polmonari più piccole mostrerebbero un maggior incremento di dimensioni delle stesse dopo BPCA. Il ruolo ed i vantaggi del flusso accessorio nella BCPA sono ancora da definire; tuttavia sembrerebbe offrire vantaggi in termini di crescita delle arterie polmonari, soprattutto il ramo lobare sinistro, e di miglior outcome dopo TCPC.
BCPA has been routinely utilized as intermediate step to Fontan operation in patients with functionally single ventricle. After 40 years since its introduction still confirms good results with low complication and mortality rate. Pulmonary arteries growth after BCPA is rather variable and inconstant with a widely reported Nakata-index reduction after some months. Right lower lobe pulmonary index instead increases significantly, possibly due to preferential blood flow after BCPA. Patients with smaller pulmonary arteries at the beginning seem to benefit of a more effective pulmonary arteries growth. Accessory source of pulmonary blood flow at the BCPA still bares uncertain efficacy and benefits, even thought it seems to be associated with a better pulmonary artery growth, particularly left lower lobe, and better TCPC results.

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Casoli, Vincent. « Un nouveau procédé de microanastomoses vasculaires par microagrafes métalliques ». Bordeaux 2, 1995. http://www.theses.fr/1995BOR23043.

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Nascimento, Ricardo Bolzam do. « Influencia da omentoplastia na anastomose colica de animais submetidos a choque hemorragico : estudo experimental em ratos ». [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309843.

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Orientadores: João Jose Fagundes, Claudio Saddy Rodrigues Coy
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A cicatrização das anastomoses intestinais constitui motivo de grande preocupação na Medicina em razão das sérias conseqüências advindas das deiscências de sutura. Os riscos são acrescidos quando anastomoses são feitas em condições de adversidade, como imunossupressão, isquemia, infecção, uso de antiinflamatórios e quimioterápicos, diabetes, trauma, desnutrição, idade avançada etc. O choque hemorrágico também é citado entre essas situações desfavoráveis, causando dano bioquímico e histológico às anastomoses, não estando bem claros os efeitos ocasionados quanto à resistência mecânica. O uso do omento como proteção à linha de sutura também não é assunto resolvido. Este trabalho tem como objetivo avaliar, através do Teste Biomecânico de Pressão de Ruptura a Distensão por Líquido (TBPRDL) a influência do grande omento sobre a linha anastomótica em animais submetidos a choque hemorrágico. Os animais eleitos como avaliáveis para serem submetidos ao teste foram àqueles que chegaram vivos e com anastomoses íntegras no dia da eutanásia. Para serem obtidos 20 animais considerados como avaliáveis para o teste biomecânico, houve necessidade de se operar 63 ratos no total. Os animais foram submetidos ao choque controlado pela retirada de sangue através de cateter colocado na carótida direita. A mortalidade entre os grupos foi semelhante com respectivamente 41,3% e 41,1% nos grupos 1 e 2. O grupo 1 em que não foi realizada a omentoplastia sobre a anastomose, apresentou 19 casos de deiscência, sendo estes descartados. No grupo 2 não foi observado nenhum caso. Entre os dois grupos não houve diferença estatística entre os parâmetros como volemia, retirada volêmica, perda ponderal, dosagens do lactato e PAM durante o experimento. Quanto ao Teste Biomecânico de Pressão de Ruptura à Distensão por Líquido (TBPRDL) o grupo 2 apresentou anastomoses mais resistentes com valores de pressão de ruptura superiores (p=0,0539) mostrando significância quando comparado ao grupo controle (G 1). Conclui-se, portanto, que a proteção omental aumentou a resistência das anastomoses e o modelo de choque hemorrágico empregado neste experimento mostrou-se útil para o estudo da cicatrização de anastomoses submetidas a essa condição de adversidade
Abstract: Intestinal anastomoses cicatrisation is a major motive for worries in Medicine due to serious consequences stemmed from suture dehiscence. Added risks happen when anastomoses are done in adverse conditions, such as immunosuppression, ischemia, infection, use of anti-inflammatory and chemotherapy drugs, diabetes, trauma, malnutrition, old age, and so on. Hemorrhagic shock is also quoted among those harmful situations, causing biochemical and histological damage to anastomoses, being the effects to mechanical resistance not clarified yet. The employment of omentum as a protection to suture line is not a concluded issue as well. This research aimed to assess via the Biomechanical Test of Pressure of Rupture by Liquid Distension (BTPRLD) the influence of a large omentum on the anastomotic line in animals submitted to hemorrhagic shock. Animals chosen as possible to be tested were those alive and presenting undamaged anastomoses at euthanasia day. In order to obtain 20 animals viable for biomechanical test analysis, 63 animals were operated on. Animals were submitted to controlled shock via catheter inserted in the right carotid. Intergroup mortality was similar, 41,3% and 41,1% respectively to group 1 and 2. Group 1, which received no omentumplasty on anastomosis, presented 19 cases of dehiscence, which were discarded. No cases were observed in group 2. There was no statistically difference between groups in parameters such as voluming, voluming suppression, ponderal loss, lactate dosage and MAP during experiment. Concerning Biomechanical Test of Pressure of Rupture by Liquid Distension (BTPRLD), group 2 presented more resistant anastomoses, with higher rupture values (p=0,0539) showing significance when compared to control group (G1). It can be concluded that omental protection increased anastomoses resistance and that the hemorrhage shock model employed was useful to the study of cicatrisation of anastomoses submitted to that adverse condition
Mestrado
Cirurgia
Mestre em Cirurgia

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Bernis, Filho Walter Octaviano. « Estudo comparativo da cicatrização entre os fios poliglecaprone, algodão e poliglactina em anastomoses de intestino delgado de cães ». [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311383.

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Orientador: Nelson Adami Andreollo
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Através dos anos muitos fios de sutura foram criados e, depois abandonados, em virtude dos bons resultados obtidos com novos fios. Ainda sim, até hoje não se encontrou um fio cirúrgico totalmente inócuo ao intestino, ou a outros tecidos de um modo geral, tornando sua escolha uma tarefa difícil. Justifica-se, a necessidade de pesquisa de novos materiais no intuito de se encontrar a opção ideal. Neste trabalho foi testado o fio poliglecaprone 25, nas anastomoses do intestino delgado de cão comparando com fios, tradicionalmente usados por outros autores na confecção de anastomoses intestinais, como os fios algodão e poliglactina 910. A cicatrização de anastomoses do intestino delgado foi avaliada, macroscópica e microscópicamente, utilizando três tipos de sutura distintos com os fios poliglecaprone 25, poliglactina 910 e o algodão. Vinte cães machos sem raça definida pesando entre 9 e 16 Kg foram submetidos, após anestesia geral inalatória, a três anastomoses no intestino delgado. A técnica empregada foi a extramucosa com pontos separados e utilizou-se, para cada uma, os fios poliglecaprone 25, a poliglactina 910 e o algodão. Os animais foram separados em 4 grupos de acordo com a avaliação do período pós-operatório: grupoI- 3 dias; grupoII- 7 dias; grupoIII- 14dias; grupo IV- 21dias. Após o período de observação, os animais foram submetidos a eutanásia para coleta de material para análise macroscópica e microscópica. Na avaliação macroscópica os três fios se comportaram bem, com boa coaptação das bordas, porém com moderado grau de aderência entre alças e epiploo, do 3º ao 21º dia do pós-operatório. A avaliação microscópica mostrou inflamação exsudativa com neutrófilos e fibrina que variou de discreta a moderada até o 14º dia; inflamação granulomatosa com presença de macrófagos, células gigantes multinucleadas e células epitelióides mais evidente ao 14º dia para o fio algodão; presença de tecido de granulação (fibroblastos) e fibras colágenas, de forma moderada, a partir do 7º dia para os três fios. Os três tipos de fios de sutura utilizados nesta pesquisa apresentaram comportamento semelhante e podem ser indicados em anastomoses do intestino delgado
Abstract: In this study was evaluate, macroscopically and microscopically, the healing process of intestinal anastomoses in dogs using polyglecaprone 25, polyglactin 910 and cotton sutures. Twenty mongrel dogs, weighting from 9 to 16 Kg were submitted, under general inhalatory anesthesia, to three small intestine anastomoses. The animals were divided into four groups, in accordance with the postoperative observation periods as follows: group I, three days; group II, seven days; group III, fourteen days; group IV, twenty one days. Extramucous technique was used, with those threads, in all four groups. After the observation period the animals were euthanized and samples from the operative site were collected for macroscopic and microscopic evaluations. Macroscopically, all three threads showed good behavior with good coaptation of the edges; however, there occurred a moderate level of adherence between loops of intestine and omentum, from day 3 to day 21, of postoperative period. Microscopically, there was exsudative inflammation, with neutrophils and fibrin, discrete to moderate until day 14. Granulomatous inflammation was also notice accompanied by macrophages, multinucleated giant cells and epithelioid cells, more evident on day 14 in the cotton group. Granulation tissue (fibroblasts) and collagen fibers were also observed, in a moderate pattern, for all three suture materials, from day 7. All three suture threads used in this research showed similar behavior and thus they can be indicated for anastomoses of the small intestine in dogs
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências

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Livres sur le sujet "Anastomosi"

Engemann, Rainer, et Arnulf Thiede, dir. Intestinal Anastomoses with Bioabsorbable Anastomosis Rings. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2.

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Salky, Barry, dir. Intracorporeal Anastomosis. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-57133-7.

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Engemann, Rainer, et A. Thiede, dir. Compression Anastomosis by Biofragmentable Rings. Berlin, Heidelberg : Springer Berlin Heidelberg, 1995. http://dx.doi.org/10.1007/978-3-642-79260-1.

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Galloro, Giuseppe, dir. Endoscopic Follow-up of Digestive Anastomosis. Milano : Springer Milan, 2014. http://dx.doi.org/10.1007/978-88-470-5370-0.

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Deitel, Mervyn, dir. Essentials of Mini ‒ One Anastomosis Gastric Bypass. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-76177-0.

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Partecke, Bernd-Dietmar. Arteriovenöse Anastomosen am arteriellen Durchstromlappen. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-95700-0.

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Hajime, Handa, Kikuchi Haruhiko, Yonekawa Yasuhiro 1939- et International Symposium on Microvascular Anastomoses for Cerebral Ischemia (6th : 1982 : Kyoto, Japan), dir. Microsurgical anastomoses for cerebral ischemia. New York : Igaku-Shoin, 1985.

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Hammerschlag, Paul E. Facial reanimation with jump interpositional graft hypoglossal facial anastomosis and hypoglossal facial anastomosis : Evolution in management of facial paralysis. [Philadelphia] : Published on behalf of the Triological Society by Lippincott Williams & Wilkins, 1999.

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Mehdorn, H. Maximillian. Microsurgical exercises : Basic techniques, anastomoses, refertilization, transplantation. Stuttgart : Thieme, 1989.

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Arden, Richard L. Microvascular free flaps in head and neck reconstruction. Alexandria, VA : American Academy of Otolaryngology--Head and Neck Surgery Foundation, 1997.

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Chapitres de livres sur le sujet "Anastomosi"

De Ritis, Rosaria, Luigi D’Anna et Francesco Di Pietto. « Stenosi di anastomosi portale post-OLT con varici perigastriche ». Dans Imaging nelle urgenze vascolari — Body, 267–68. Milano : Springer Milan, 2008. http://dx.doi.org/10.1007/978-88-470-1072-7_134.

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Lünstedt, B., R. Engemann, S. Debus, L. Lim et A. Thiede. « The Healing Process of Anastomoses with Bioabsorbable Rings : An Experimental Study in Pigs ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 3–12. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_1.

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Gruwez, J. A., J. Lerut, L. Verougstraete, M. R. Christiaens, W. Coosemans, M. Philippe, J. Verbruggen et I. de Wever. « Clinical Experience with the Bioabsorbable Anastomosis Ring in Bowel Surgery ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 67–74. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_10.

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Thiede, A., R. Engemann, S. Vogel et B. Lünstedt. « Multiple Application of the Bioabsorbable Anastomosis Ring in Gastrointestinal Surgery ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 75–93. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_11.

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Vogel, S., R. Engemann et A. Thiede. « The Application of Special Instruments with the Bioabsorbable Anastomosis Ring : Technology and Technical Aspects ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 13–19. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_2.

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Schindler, G., R. Engemann, W. Schmitz et A. Thiede. « Standardized X-Ray Examination of the Bioabsorbable Ring Anastomosis ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 21–28. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_3.

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Cahill, C. J. « Multicentre European Prospective Randomized Trial of the Valtrac Bioabsorbable Anastomosis Ring ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 31–35. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_4.

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Havia, T. « Prospective Trial of the Bioabsorbable Anastomosis Ring in Gastrointestinal Surgery ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 37–40. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_5.

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Engemann, R., B. Lünstedt, S. Vogel et A. Thiede. « Prospective Study of Results and Complications in 304 Bioabsorbable Ring Anastomoses in the Upper and Lower Gastrointestinal Tract ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 41–50. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_6.

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Dietz, W. « Occlusion Ileus Due to Blood Clots Following Right Hemicolectomy : A Rare Complication ». Dans Intestinal Anastomoses with Bioabsorbable Anastomosis Rings, 53–57. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78017-2_7.

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Actes de conférences sur le sujet "Anastomosi"

Ballyk, Peter D., Matadial Ojha et Colin Walsh. « Comparing the Influence of Graft Angle on Peri-Anastomotic Wall and Fluid Mechanics ». Dans ASME 1997 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1997. http://dx.doi.org/10.1115/imece1997-0248.

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Abstract Distal anastomotic intimal hyperplasia (DAIH) can lead to outflow stenosis of vascular bypass grafts. In end-to-side graft-artery anastomoses, two separate regions of DAIH have been identified: (i) the suture line and (ii) the floor of the anastomosis across from the suture line (Bassiouny et al., 1992). Suture-line intimal thickening seems to be associated with post-surgical healing and influenced by graft-artery compliance mismatch (Trubel et al., 1994), while floor hyperplasia appears to be linked to fluid mechanical phenomena, such as temporal variations in wall shear stress (Ojha, 1994).

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Morbiducci, Umberto, Raffaele Ponzini, Matteo Nobili et Alberto Redaelli. « Magnetic Vascular Positioner for Automatic Coronary Artery Bypass Grafting Does Not Significantly Increase the Risk of Failure Related to Local Fluid Dynamics : A Numeric Study ». Dans ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176350.

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Anastomotic devices have been recently introduced in cardiac surgery, in order to make the anastomosis procedure more quick, automatic and efficient. The Ventrica magnetic vascular positioner (MVP) constitutes an attractive anastomotic option that significantly shortens the ischemic time when creating the coronary anastomosis on the beating heart [1]. However, the implantation of the MVP connector modifies the graft configuration, consistently affecting the hemodynamics usually found in the traditional anastomosis. As local fluid dynamics could play a significant role on the onset of vessels’ wall pathologies, in this study a computational approach was designed to investigate the flow patterns in presence of the MVP. To do this, a model of standard hand-sewn anastomosis and a model of automated anastomosis were constructed, and CFD was used to simulate realistic graft hemodynamics. Synthetic analytical methods were calculated and compared for the quantitative assessment of the role played by the fluid dynamics in the activation of mechanotransduction pathways at the vessel wall, i.e., time-averaged wall shear stress (TAWSS), oscillating shear index (OSI) [2], and the very recent helical flow index HFI [3, 4]. This allowed to evaluate if the use of the MVP design increases the risks of failure related to the local bypass fluid dynamics.

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Bonert, Michael, Jerry G. Myers, Stephen E. Fremes et C. Ross Ethier. « Influence of Graft/Host Diameter Ratio on the Hemodynamics in Sequential ITA Anastomoses ». Dans ASME 2000 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/imece2000-2612.

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Abstract Multivessel grafting with internal thoracic artery (ITA) conduits may improve the long-term results of coronary surgery for patients with multivessel coronary disease. Sequential ITA grafting has been increasingly used as a means of allowing a single ITA to revascularize a greater amount of the myocardium (Izzat et al, 1994). In this procedure, the graft first supplies blood to a coronary artery via a side-to-side anastomoses and then delivers blood to a second site in the coronary vasculature through an end-to-side anastomosis. However, it is unclear if the complex geometry and hemodynamic patterns in the side-to-side anastomosis contribute to the development of intimal hyperplasia, as reported for end-to-side anastomoses (Bassiouny et al. 1992). In a previous study we studied the hemodynamics of side-to-side anastomosis when graft and host diameters are equal (Bonert et al., 1999). In this study, we examined the wall shear stress (WSS) characteristics in idealized models of a “parallel” and a “diamond” side-to-side anastomoses for the case in which the graft diameter is substantially larger than the host diameter (Lei et al., 1996). Regions of specific interest were those exhibiting low WSS and rapidly changing WSS (high spatial WSS gradient) both of which have been suggested to promote intimal hyperplasia.

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Gray, Jonathan D., Ieuan Owen et Marcel P. Escudier. « An Experimental Study of the Effects of Non-Newtonian Blood Rheology in a Large Scale Model of a Distal Anastomosis ». Dans ASME 2001 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2001. http://dx.doi.org/10.1115/imece2001/bed-23137.

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Abstract This paper is concerned with determining experimentally the extent to which the assumption of blood being a Newtonian fluid affects the flow through a distal anastomosis. While many authors studying vascular fluid mechanics are turning their attention to geometrical considerations, the importance of the non-Newtonian effect is still unclear, and has yet to be experimentally quantified for anastomotic flows. The study reported in this paper aims to address the problems inherent in any comparison between a Newtonian and non-Newtonian flow by investigating qualitative Reynolds number trends in the flow characteristics for both types of fluid. Estimates are then made regarding the quantitative differences that may be expected when using a Newtonian fluid to represent blood flow through an anastomosis.

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DiCicco, John R., et Ayodeji O. Demuren. « Distal Placement of an End-to-Side Bypass Graft Anastomosis : A 3-D Computational Study ». Dans ASME 2005 Fluids Engineering Division Summer Meeting. ASMEDC, 2005. http://dx.doi.org/10.1115/fedsm2005-77332.

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A three-dimensional (3-D) computational fluid dynamics study of shear rates around distal end-to-side anastomoses has been conducted. Three 51% and three 75% cross-sectional area reduced 6 mm cylinders were modeled each with a bypass cylinder attached at a 30 degree angle at different placements distal to the constriction. Steady, incompressible, Newtonian blood flow was assumed, and the full Reynolds-averaged Navier-Stokes equations and turbulent kinetic energy and specific dissipation rate equations were solved on a locally structured multi-block mesh with hexahedral elements. Consequently, distal placement of an end-to-side bypass graft anastomosis was found to have an influence on the shear rate magnitudes. For the 75% constriction, closer placements produced lower shear rates near the anastomosis. Hence, there is potential for new plaque formation and graft failure.

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El Zahab, Zaher, Eduardo A. Divo et Alain J. Kassab. « A Genetic-Algorithm-Based Design Approach to Minimize Abnormal Hemodynamics Parameters at the End-to-Side Distal Anastomoses of Synthetic Bypass Grafts ». Dans ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176718.

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Medical records on post-operative performances of synthetic bypass grafting show poor results due to the re-stenosis occurring at the end-to-side distal (ETSD) anastomoses of the grafts. The re-stenosis is mainly caused by intimal hyperplasia (IH) [1]. A major factor behind the anastomotic IH development is the non-physiological flow patterns, such as separation and re-attachment, resulting from the bifurcating nature of the anastomotic geometry [2]. The spatial wall shear stress gradient (SWSSG) has been experimentally proven to cause proliferation and migration of the endothelial cells [3], resulting in an endothelial dysfunction that potentially leads to the initiation of IH.

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Badimon, J. J., L. Badimon, A. Galvez, J. Camunas et V. Fuster. « DYNAMICS AND LOCALIZATION OF PLATELET DEPOSITION ON A SYNTHETIC VASCULAR GRAFT : CONTINUOUS IMAGING ». Dans XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643954.

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The in vivo dynamics of thrombus formation have not been extensively studied, mainly due to technical limitations. We assessed the dynamics and localization of platelet deposition on a prosthetic vascular graft for the first 24 hours after implantation in swine, with continuous monitoring during the initial 6 hours, and the effect of heparin. Polytetrafluoro-ethylene (PTFE) grafts (5cm. L × 0.5 cm. ID) were inplanted in one of the common carotids of 13 normal pigs; 8 received iv heparin (150uAg) perioperatively. 111 In-labelled autologous platelets were injected 5 min before reperfusion of the graft. From 10 min to 24 hrs after unclamping the vessel sequential gamma camera images of the neck were taken and stored in an on-line computer. Pinpoint analysis of the platelet deposition was performed by creating seven regions of interest of 5 × 5 pixels over both graft and contralateral carotid territories. We obtained the ratio of the 111 In-activity in each region of the graft, including both anastomoses, with respect to its contralateral homologous region. The ratios differed along the graft in both groups of animals, with maximal values at the anastomosis. Peak ratios were reached within 1 to 3 hrs, and were significatively lower in heparinized pigs (anastomosis: 1.95±0.36; graft: 1.3±0.66) than in rion-heparinized-pigs (anastomosis: 3.23±0.66; graft: 2.16±0.41; p<0.05). Heparinized pigs showed a progressive decrease of the ratios up to 24 hrs. In contrast, platelet deposition in non-heparinized-pigs continued up to 6 hrs. Patency at 24 hrs was 88% in heparinized-pigs versus 20% in non-heparinized-pigs. We conclude that computer assisted pinpoint analysis of platelet deposition may help to a better understanding of the thrombotic process differentiating platelet-graft interaction from platelet anastomosis interaction. The deposition of platelets and graft patency is strongly influenced by the stabilizing effect of procoagulant moieties, and the presence of the anastomosis (release of vessel wall procoagulant and platelet activating products and induction of blood flow disturbances) induces localized activation and deposition of platelets.

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Galvin, DAJ, A. C. Meek, P. Pate et C. N. McCollum. « DO PLATELET INHIBITORS INCREASE OPERATIVE BLOOD LOSS ? » Dans XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644225.

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Although platelet inhibitory therapy improves arterial graft patency, surgeons are anxious that preoperative administration may increase operative bleeding. We investigated the effect of platelet inhibitors on blood loss during femoral artery replacement in dogs.Thirty greyhounds were randomised to receive placebo, a thromboxane antagonist GR32191 25mg (Glaxo Group Research) or aspirin 150mg (ASA) plus dipyridamole 50mg (DPM) twice daily starting 48 hours prior to implanting a 6cm length of 6mm PTFE in the femoral artery using standardised incision, mobilisation and anastomosis with 6.0 prolene. All bleeding was collected in swabs which were then thoroughly washed in 2L heparinised saline. The erythrocytes were haemolysed by adding potassium cyanide and the haemoglobin concentration measured in a Coulter Haemoglobinometer (Coulter Electronics). Blood loss was calculated by comparison to 1:500 dilution of the same animal’s venous blood. The bleeding time of the arterial anastomosis was also recorded.The mean (± sem) blood loss was similar in all three groups tending to be slightly less with GR32191 and ASA ± DPM at 135125 and 115±121 mis respectively, compared to 152±129 mis on placebo (NS). Anastomosis bleeding time appeared to be prolonged at 390±131 secs by the thromboxane antagonist compared to 291±40 with placebo and 224±136 with ASA and DPM, but this difference did not achieve statistical significance. There was a significant correlation (r=0.53) between blood loss and anastomotic bleeding time (p<0.001).This method of measuring blood loss is easily applicable to patients and does not demonstrate any important tendency to increased bleeding with preoperative platelet inhibitors.

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Al-Kharraz, Heba, Rahaf Nader, Maha Al-Asmakh et Jessica P. Johnson. « In Vitro Comparison of Two Single Layer Hand Sewn End-to-End Anastomosis Techniques in Normal Equine Jejunum : A Pilot study ». Dans Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0192.

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Background: The equine small intestine can be affected by a variety of disorders, which may require some form of bypass or anastomosis procedure. Several small intestinal anastomosis techniques have been reported in scientific literature with the intention to minimize post-operative complications, however to our knowledge there are no published descriptions of the hand-sewn end-to-end single layer simple continuous Appositional technique for equine jejunojejunostomy. Objective: To compare and evaluate differences in the single layer continuous Appositional and the single layer continuous Lembert with respect to construction time, leakage pressure and bursting pressure; for the purpose of small intestinal anastomosis in the horse. Hypothesis: We hypothesized that the time spent in the execution, leakage pressure and bursting pressure will be similar between the single layer continuous Lembert and the single layer simple continuous Appositional techniques. Since this is a pilot study, it is the first step to prove the efficacy of the Appositional technique by showing its similarity with the Lembert technique, considering the latter to be the ‘gold standard’. Methodology: Thirty-Seven intestinal segments from two horses were used to compare the single layer continuous Appositional and single layer continuous Lembert techniques. The time taken to execute the anastomoses, and the number of bites taken for each pattern, were recorded. Biomechanical testing was performed to determine leakage pressure and bursting pressure. Statistical analysis was performed using GraphPad Prism 8. Result: The comparison in construction time between the Lembert group (mean, 24.23 mins, n=19) and the Appositional group (mean, 21.74 mins, n=18) were found to be statistically insignificant (P=0.3088). There was also no changes in Leakage pressure (P=0.3862) and bursting pressure (P=0.3135) between the two groups. Conclusion: This study has demonstrated that the Appositional technique is a viable alternative to the Lembert technique, with respect to construction time, leakage and bursting pressures, for the purpose of end-to-end jejunojejunal anastomosis in the horse

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Alkharraz, Heba, Rahaf Nader, Maha Al‐ Asmakh et Jessica Johnson. « In Vitro Comparison of Two Single Layer Hand Sewn end‐to‐end Anastomosis Techniques in Normal Equine Jejunum : A Pilot Study ». Dans Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0198.

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Background: The equine small intestine can be affected by a variety of disorders, which may require some form of bypass or anastomosis procedure. Several small intestinal anastomosis techniques have been reported in scientific literature with the intention to minimize post-operative complications, however to our knowledge there are no published descriptions of the hand-sewn end-to-end single layer simple continuous Appositional technique for equine jejunojejunostomy. Objective: To compare and evaluate differences in the single layer continuous Appositional and the single layer continuous Lembert with respect to construction time, leakage pressure and bursting pressure; for the purpose of small intestinal anastomosis in the horse. Hypothesis: We hypothesized that the time spent in the execution, leakage pressure and bursting pressure will be similar between the single layer continuous Lembert and the single layer simple continuous Appositional techniques. Since this is a pilot study, it is the first step to prove the efficacy of the Appositional technique by showing its similarity with the Lembert technique, considering the latter to be the ‘gold standard’. Methodology: Thirty-Seven intestinal segments from two horses were used to compare the single layer continuous Appositional and single layer continuous Lembert techniques. The time taken to execute the anastomoses, and the number of bites taken for each pattern, were recorded. Biomechanical testing was performed to determine leakage pressure and bursting pressure. Statistical analysis was performed using GraphPad Prism 8. Results: The comparison in construction time between the Lembert group (mean, 24.23 mins, n=19) and the Appositional group (mean, 21.74 mins, n=18) were found to be statistically insignificant (P=0.3088). There was also no changes in Leakage pressure (P=0.3862) and bursting pressure (P=0.3135) between the two groups. Conclusion: This study has demonstrated that the Appositional technique is a viable alternative to the Lembert technique, with respect to construction time, leakage and bursting pressures, for the purpose of end-to-end jejunojejunal anastomosis in the horse.

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Rapports d'organisations sur le sujet "Anastomosi"

Ethicon, Inc. Vascular Anastomosis. Touch Surgery Simulations, 2015. http://dx.doi.org/10.18556/touchsurgery/2015.s0097.

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Parmar, Chetan. Mini (One Anastomosis) Gastric Bypass. Touch Surgery Publications, mars 2019. http://dx.doi.org/10.18556/touchsurgery/2016.s0158.

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Parmar, Chetan. Mini (One Anastomosis) Gastric Bypass. Touch Surgery Simulations, mars 2019. http://dx.doi.org/10.18556/touchsurgery/2019.s0158.

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Pathak, Ram, et Joseph Costa. Formation of an ileal conduit : the Wallace anastomosis. BJUI Knowledge, décembre 2018. http://dx.doi.org/10.18591/bjuik.0093.v2.

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Spencer, Kalli, et Vincent Tse. Anastomotic urethroplasty for anterior urethral stricture disease. BJUI Knowledge, novembre 2019. http://dx.doi.org/10.18591/bjuik.0689.

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Deana, Naira, et Nilton Alves. Anastomosis between the posterior superior alveolar artery and the infra-orbital artery : systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, août 2021. http://dx.doi.org/10.37766/inplasy2021.8.0071.

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Grozdev, Konstantin, Nabil Khayat, Angel Arabadzhiev et Kostadin Angelov. Technique of Totally Laparoscopic Treatment of Diverticular Colovesical Fistula with Transanal Colorectal Anastomosis and Urinary Bladder Repair. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, décembre 2021. http://dx.doi.org/10.7546/crabs.2021.12.15.

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KHAIRALLAH, Sara, et EL HARROUDI Tijani. Delayed coloanal anastomosis technique in the management of low-lying rectal cancer : systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, février 2022. http://dx.doi.org/10.37766/inplasy2022.2.0002.

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Review question / Objective: Is there a difference in terms of post-operative events between delayed and immediate coloanal anastomoses in the management of rectum carcinoma? Condition being studied: Rectal carcinoma. Eligibility criteria: We defined the lower rectum as any rectal tumor located within 6cm of the anal margin or within 2cm of the upper edge of the sphincter ring.- All scientific articles published or not published between 01/1985 and 09/2021 that aim to demonstrate the postoperative, oncological and functional results of ACAD in the curative treatment of adenocarcinoma of the lower rectum or rectal cancer including the lower rectum.- Scientific articles that discuss case series treated with ACAD in different benign or malignant pathologies, but where patient data and results of this procedure are well individualized in patients operated on rectal adenocarcinoma. - Abstracts of conference sessions, theses or unpublished articles (grey literature) with complete data, allowing their extraction and processing in our review.Translated with http://www.DeepL.com/Translator (free version).

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Li, Zhenglu, Ailin Wei, Ning Xia, Liangxia Zheng, Dujiang Yang, Jun Ye, Junjie Xiong et Weiming Hu. Is Blumgart anastomosis superior to conventional pancreaticojejunostomy after pancreaticoduodenectomy ? A protocol for a systematic review and meta-analysis. International Platform of Registered Systematic Review and Meta-analysis Protocols, mai 2020. http://dx.doi.org/10.37766/inplasy2020.5.0012.

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Zhang, Tuo, Yigong Sun et Weizheng Mao. Meta‑analysis of randomised controlled trials comparing intracorporeal versus extracorporeal anastomosis in minimally invasive right hemicolectomy : upgrading the level of evidence. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, mars 2023. http://dx.doi.org/10.37766/inplasy2023.3.0011.

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