Objective: To evaluate a novel microvascular anastomosis technique using N-fibroin stents.
Study Design: Cylinder stents of 1 mm diameter and 5 mm length were fabricated using N-fibroin from silkworms. In 22 rats, aortas were dissected, and the stent was inserted into the two ends of the aorta and fixed using methylmethacrylate.
Results: Stent anastomosis was successful in 21 (96%) rats. The mean ischemia time was 7.4 minutes, significantly shorter than the 15.9 minutes in the control group with conventional sutures (P < .0001). After 4 months, anastomosis was functionally patent in all cases. However, elastic fibers remained interrupted in all stent anastomosis cases, and marked host rejection was evident at the stent anastomosis sites. Around the stents, thrombi were frequent (52%).
Conclusions: Our study demonstrated the basic feasibility of stent anastomosis using N-fibroin stents and reduced ischemia time. However, thrombus formation, frequent and severe abdominal infections, and heavy host rejection remain critical issues.
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http://dx.doi.org/10.1016/j.oooo.2016.01.009 | DOI Listing |
Front Surg
December 2024
Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
Objectives: To present our initial experience of robotic ureteroplasty with lower-lip mucosal graft (LLMG) for treating ureteral stenosis longer than 2 cm and evaluate its feasibility and efficacy.
Materials And Methods: A total of thirteen patients with ureteral stenosis who underwent robotic ureteroplasty with LLMG were retrospectively analyzed. After identification and dissection of the ureteral stenosis segment, the segment was incised longitudinally.
Ann Hepatobiliary Pancreat Surg
December 2024
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Bile duct injuries are a serious issue, and their surgical treatment carries the risk of morbidity and mortality. In selected cases, non-surgical treatments are possible, even for total strictures. We outline the technique and results of using magnetic compression anastomosis (MCA) to treat post-cholecystectomy bile duct stricture (PCBDS), in two female patients.
View Article and Find Full Text PDFAsian J Endosc Surg
December 2024
Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
A case of redo pyeloplasty using robot-assisted retroperitoneoscopic pyeloplasty (RARP) for failed primary laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) is reported. A 12-year-old boy had LP elsewhere. He was referred for management of persistent left hydronephrosis, but was managed conservatively due to minimal symptoms and stable radioisotopic renography.
View Article and Find Full Text PDFKyobu Geka
December 2024
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
A 61-year-old female underwent ascending aortic replacement (resecting the primary entry in the ascending aorta) for Stanford type A acute aortic dissection 1 year and 8 months before. Her postoperative course was uneventful, and the patient was discharged on 17 days later. Follow-up recent computed tomography (CT) scans, however, revealed dissecting aortic aneurysm of the distal aortic arch due to a new entry at the distal anastomosis of the ascending replacement.
View Article and Find Full Text PDFSemin Vasc Surg
December 2024
Division of Vascular and Endovascular Surgery, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, Boston Medical Center, 88 East Newton Street, Boston, MA 02118. Electronic address:
Hemodialysis (HD) access for patients with end-stage renal disease is a steadily increasing necessity, and maintaining patency of native or synthetic fistulas can be challenging. The main physiologic changes of an HD access that cause it to fail are inflow or outflow vessel stenosis or access thrombosis. These are propagated by factors intrinsic to end-stage renal disease, altered hemodynamics from a fistula, and typically further exacerbated by associated comorbidities.
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