Evaluating microscopic arterial reconstruction: a comparison of laser-assisted versus conventional vascular...

The influence of deteriorated liver function on the healing process of arterial anastomosis was investigated in rats who underwent arterial reconstruction by the microscopic surgical techniques of conventional sutured vascular anastomosis (CSVA) and laser-assisted vascular anastomosis (LAVA). After 70% hepatectomy, the arterial ketone body ratio, reflecting the hepatic mitochondrial redox state, and the adenylate energy charges of the platelets, polymorphonuclear leukocytes and mononuclear cells, which play an important role in wound healing, were significantly lower in hepatectomized rats than in control. Tensile strength and bursting pressure with CSVA at the abdominal aortic anastomosis were also significantly lower in hepatectomized rats than in control. While CSVA was superior to LAVA in tensile strength, bursting pressure and incidence of aneurysm formation in nonhepatectomized rats, LAVA tended to show a lower degree of disadvantage in hepatectomized rats than CSVA, especially in the incidence of calcification at the anastomotic site. It was concluded that LAVA would be a useful option in vascular anastomosis, even during extended hepatectomy.