Intestinal atresia: an end-to-end linear anastomotic technique

2001 ◽  
Vol 17 (8) ◽  
pp. 661-663 ◽  
Author(s):  
V. K. Patil ◽  
B. K. Kulkarni ◽  
A. Jiwane ◽  
P. Kothari ◽  
S. Poul
Keyword(s):  
Intestinal Atresia ◽  
Anastomotic Technique ◽  
End To End

scholarly journals Outcome Analysis of End-to-End and End-to-Side Anastomoses in 131 Patients Undergoing Microsurgical Free Flap Reconstruction of the Lower Extremity

2016 ◽  
Vol 02 (01) ◽  
pp. e7-e14
Author(s):  
Sören Könneker ◽  
G.F. Broelsch ◽  
J.W. Kuhbier ◽  
T. Framke ◽  
N. Neubert ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Statistical Significance ◽  
Group Versus ◽  
Outcome Analysis ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Flap Survival ◽  
Anastomotic Technique ◽  
End To End

Background End-to-end and end-to-side anastomoses remain the most common techniques in microsurgical free flap reconstruction. Still, there is an ongoing effort to optimize established techniques and develop novel techniques. Numerous comparative studies have investigated flow dynamics and patency rates of microvascular anastomoses and their impact on flap survival. In contrast, few studies have investigated whether the type of anastomosis influences the outcome of microvascular free flap reconstruction of a lower extremity. Patients and Methods Retrospectively, we investigated the outcome of 131 consecutive free flaps for lower extremity reconstruction related to the anastomotic technique. Results No statistical significance between arterial or venous anastomoses were found regarding the anastomotic techniques (p = 0.5470). However, evaluated separately by vessel type, a trend toward statistical significance for anastomotic technique was observed in the arterial (p = 0.0690) and venous (p = 0.1700) vessels. No thromboses were found in arterial end-to-end anastomoses and venous end-to-side anastomoses. More venous (n = 18) than arterial thromboses (n = 9) occurred in primary anastomoses undergoing microsurgical free flap reconstruction (p = 0.0098). Flap survival rate was 97.37% in the end-to-end arterial group versus 86.36% in the end-to-side group. No thromboses were found in five arterial anastomoses using T-patch technique. Conclusion For lower extremities, there is a connate higher risk for venous thrombosis in anastomotic regions compared with arterial thrombosis. We observed divergent rates for thromboses between end-to-end and end-to-side anastomoses.However, if thrombotic events are explained by anastomotic technique and vessel type, the latter carries more importance.

scholarly journals Management and Outcomes of Malformations Associated with Intestinal Malrotations in Newborns: About 5 Cases

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Monsoïa Gildas Yassegoungbe ◽  
Médard Ayawo Guedenon ◽  
Géraud Garcia Philemon Satingo Segbedji ◽  
Codjo Serge Metchihoungbe ◽  
Mahussi Henok Orion Akokpe ◽  
...  
Keyword(s):  
Intestinal Anastomosis ◽  
Intestinal Atresia ◽  
The Other ◽  
Intestinal Loop ◽  
Jejunal Atresia ◽  
Ladd Procedure ◽  
Embryonic Life ◽  
End To End ◽  
Multiple Intestinal Atresia ◽  
Fatal Complications

Bowel malrotation is an abnormality in the rotation of the primary intestinal loop during embryonic life. It is a severe abnormality exposing the patient to fatal complications. We report here a series of five patients presenting digestive malrotation with various malformative associations. The first three cases are multiple intestinal atresia on incomplete common mesentery. They underwent an intestinal anastomosis: end-lateral duodeno-ileal for one and end-to-end jejuno-jejunal for the other two with Ladd procedure. In the latter two cases, the omphalocele was the associated malformation; complications such as rupture of the omphalocele with intestinal perforation for one and occlusion by strangulation at the level of the neck for the other were recorded. Ileal resection removing the perforation with end-to-end ileo-ileal anastomosis was performed for the first, while reduction of strangulation at the origin of the occlusion was sufficient for the second. The LADD procedure was the complementary gesture in all cases. The outcome was favorable in 3 cases; two of the newborns who had jejunal atresia died, one on day 5 in a picture of acute respiratory distress, the other on day 6 in a picture of disseminated intravascular coagulation.

Regeneration of the transected rat sciatic nerve after suturing or adhesion with cyanoacrylate glue

2011 ◽  
Vol 114 (1) ◽  
pp. 245-252 ◽  
Author(s):  
Jonathan Roth ◽  
Jonathan Shtokman ◽  
Merav H. Shamir ◽  
Moshe Nissan ◽  
Leonid Shchetinkov ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Cyanoacrylate Glue ◽  
Traditional Treatment ◽  
Anastomotic Technique ◽  
Rat Sciatic Nerve ◽  
Suture Group ◽  
Nerve Model ◽  
End To End

Object Traditional treatment of transected peripheral nerves has been by suturing the nerve ends to each other. Because this approach is not widely available and is technically demanding, the authors evaluated an easier method for end-to-end anastomosis using cyanoacrylate-based glue. Methods The authors used a rat sciatic nerve model. The sciatic nerve was transected in one hind limb in each of 40 rats. In 20 rats, end-to-end anastomosis was performed with suturing, while in the other 20 it was performed using only cyanoacrylate glue. The outcome variables were incapacitance test results; the functional sciatic index; somatosensory evoked potentials; axon counts and sizes at the proximal, anastomotic, and distal levels; local adhesions; and automutilation injuries. Outcomes were measured in a manner blinded to the anastomotic technique. Results Only the somatosensory evoked potentials and degree of local adhesions were significantly better in the Suture Group than in the Glue Group. With respect to the remaining outcomes (automutilation injuries, counts of large and medium axons combined, and counts of small axons), either the results were significantly better in the Glue Group or the between-groups difference was not statistically significant. There were no consistent significant correlations between the various outcome measures. Conclusions Using cyanoacrylate-based glue for microanastomosis of cut nerves appears to be as effective as microsuturing the nerve ends. Despite more local adhesions in the glued nerves, most functional outcomes were not influenced by the anastomotic technique. Validation of these findings awaits studies of larger groups of animals.

Comparison of Outcomes of End-to-End versus End-to-Side Anastomoses in Lower Extremity Free Flap Reconstructions

2020 ◽  
Vol 36 (06) ◽  
pp. 432-437 ◽  
Author(s):  
Peter Niclas Broer ◽  
Nicholas Moellhoff ◽  
Julius M. Mayer ◽  
Paul I. Heidekrueger ◽  
Milomir Ninkovic ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Free Flaps ◽  
Arterial Disease ◽  
Muscle Flaps ◽  
Anastomotic Technique ◽  
Arterial Anastomosis ◽  
End To End ◽  
Peripheral Arterial ◽  
The Impact

Abstract Background Whether to perform an end-to-end (ETE) versus end-to-side (ETS) arterial anastomosis is an integral part of preoperative planning and intraoperative decision making in free flap-based reconstructions. This study evaluated the impact of microsurgical anastomotic technique on outcomes of lower extremity reconstructions, with a focus on patients with peripheral arterial disease (PAD). Methods Over a 6-year period, 425 patients underwent 437 microvascular lower extremity free flap reconstructions with fasciocutaneous anterolateral thigh- or gracilis muscle flaps at a single surgical center. The cases were divided into an ETE (n = 297 patients) versus ETS (n = 128 patients) group according to the anastomotic technique. A retrospective analysis of patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and the potential impact of PAD on outcomes was performed. Patient groups were comparable regarding comorbidities, American Society of Anesthesiologists scores, types of performed free flaps and recipient sites. Results We found no significant differences between the ETE versus ETS groups regarding the rate of major or minor complications (p > 0.05). Specifically, in patients suffering from PAD (n = 64) the type of arterial anastomosis had no effect on the outcome. Conclusion Overall, no significant differences in outcomes were observed when comparing the types of performed arterial anastomosis. This observation also held true for the subgroup of patients with PAD. Given that an ETS anastomosis did not increase the risk to encounter complications while preserving distal perfusion, we believe that this technique is the method of choice, especially in patients with impaired vascular status.

Surgical management of extracranial carotid artery aneurysms

VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Jan Paweł Skóra ◽  
Jacek Kurcz ◽  
Krzysztof Korta ◽  
Przemysław Szyber ◽  
Tadeusz Andrzej Dorobisz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Surgical Management ◽  
Minor Stroke ◽  
Stroke Rate ◽  
Extracranial Carotid Artery ◽  
Long Term Follow Up ◽  
End To End ◽  
Dacron Patch ◽  
Major Stroke

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review

2020 ◽  
Author(s):  
Ahmed Mousa ◽  
Ossama M. Zakaria ◽  
Mai A. Elkalla ◽  
Lotfy A. Abdelsattar ◽  
Hamad Al-Game'a
Keyword(s):  
Severity Score ◽  
Vein Graft ◽  
Bypass Surgery ◽  
Age Groups ◽  
Vascular Injuries ◽  
Peripheral Vascular ◽  
Group Iii ◽  
Mangled Extremity ◽  
Group I ◽  
End To End

AbstractThis study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Patients were divided into three different age groups. Group I included those children between 5 and 10 years; group II involved pediatrics between 11 and 15 years; while children between 16 and 21 years participated in group III. We recruited 183 children with peripheral vascular injuries. They were 87% males and 13% females, with the mean age of 14.72 ± 04. Arteriorrhaphy was performed in 32%; end-to-end anastomosis and natural vein graft were adopted in 40.5 and 49%, respectively. On the other hand, 10.5% underwent bypass surgery. The age groups I and II are highly susceptible to penetrating trauma (p = 0.001), while patients with an extreme age (i.e., group III) are more susceptible to blunt injury (p = 0.001). The MESS has a significant correlation to both age groups I and II (p = 0.001). Vein patch angioplasty and end-to-end primary repair should be adopted as the main treatment options for the repair of extremity vascular injuries in children. Moreover, other treatment modalities, such as repair with autologous vein graft/bypass surgery, may be adopted whenever possible. They are cost-effective, reliable, and simple techniques with fewer postoperative complication, especially in poor/limited resources.

WS-Security on PRODML

2014 ◽  
Vol 1 (1) ◽  
pp. 9-34
Author(s):  
Bobby Suryajaya
Keyword(s):  
Web Services ◽  
Digital Signature ◽  
Data Transfer ◽  
Web Services Security ◽  
Soap Message ◽  
Simulation Results ◽  
End To End

SKK Migas plans to apply end-to-end security based on Web Services Security (WS-Security) for Sistem Operasi Terpadu (SOT). However, there are no prototype or simulation results that can support the plan that has already been communicated to many parties. This paper proposes an experiment that performs PRODML data transfer using WS-Security by altering the WSDL to include encryption and digital signature. The experiment utilizes SoapUI, and successfully loaded PRODML WSDL that had been altered with WSP-Policy based on X.509 to transfer a SOAP message.

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