End-to-end and end-to-side microvascular anastomoses: a comparative study

Area of Science:

• Microsurgery
• Vascular Surgery
• Surgical Techniques

Background:

• The choice between end-to-end and end-to-side anastomosis in microsurgery is debated.
• Specific clinical scenarios necessitate proficiency in both techniques, such as managing vessel size discrepancies or preserving donor vessel flow.

Purpose of the Study:

• To compare the outcomes of arterial and venous end-to-end versus end-to-side anastomoses in a rat free flap model.
• To evaluate the utility of dermofluorometry for immediate postoperative flap viability assessment.

Main Methods:

• A rat free flap model was utilized to compare arterial and venous anastomoses.
• Fifteen animals were allocated to each of the four anastomosis groups (arterial end-to-end, arterial end-to-side, venous end-to-end, venous end-to-side).
• Flap survival rates were recorded, and dermofluorometry was employed for early postoperative perfusion monitoring.

Main Results:

• Flap survival rates exceeded 80% in all anastomosis groups.
• No significant difference in survival was observed between end-to-end and end-to-side anastomosis types for either arteries or veins.
• Dermofluorometry did not prove useful in predicting flap viability in the early postoperative period.

Conclusions:

• Both end-to-end and end-to-side anastomosis techniques demonstrate comparable flap survival rates in this rat model.
• Dermofluorometry is not a reliable tool for immediate postoperative flap viability assessment in this setting.