Anterior-interrupted and posterior-continuous suture technique improved the success rate of kidney transplantation model in rats.

PURPOSE: This study aimed to introduce and evaluate two new microvascular anastomosis techniques compared to the conventional method in a rat renal transplant model. METHODS: Using a Fisher-to-Lewis rat kidney transplantation model, the renal artery anastomosis was performed using the interrupted (I) suture technique, Y-shaped continuous (Y) suture technique, and anterior-interrupted and posterior-continuous (I-C) suture technique. The rats were then divided into three groups: I group, Y group, and I-C group. Parameters such as arterial anastomosis time, warm ischemia time, seven-day survival rate of the rats, and vessel histopathology were assessed. RESULTS: The mean arterial anastomosis time, blood leakage scores, and warm ischemia time were significantly reduced in groups Y and I-C compared to group I. Moreover, the seven-day survival rate was significantly higher in the I-C group compared to the other two groups. Arterial histopathology demonstrated vessel wall recovery without damage in all three groups, suggesting the safety of both Y and I-C techniques. CONCLUSIONS: The anterior-interrupted and posterior-continuous suture method is particularly beneficial for small artery reconstruction in organ transplantation.

Snake-Eye Screwing: A Novel Free-Hand Technique of Pedicle Screw Placement in Cervicothoracic Spine and Preliminary Clinical Results.

OBJECTIVE: To propose a novel technique of free-hand pedicle screw placement in cervicothoracic spine (snake-eye method) and evaluate the preliminary effects and safety in clinical practice. METHODS: This is a retrospective study and we defined the period of this study as from December 2017 to April 2019 in our institution. Forty patients were included in this study who underwent cervicothoracic internal fixation in our hospital, and all patients undergoing implantation of 200 pedicle screws were divided into two groups. Twenty-two patients (108 screws) had screw placement using traditional method, while 18 patients (92 screws) had screw placement using snake-eye method. To reduce the possible selection bias, the patients we recruited in this study was originally performed on by one radiological doctor who was blind to the objective of this study. Patient demographics, including patient age, sex, obesity, smoking, and hypertension, were evaluated to figure out baseline differences between groups. Medical information was recorded including time, accuracy, and immediate (within 30 days after surgery) postoperative complications of pedicle screw placement (including pulmonary embolism or other thromboembolic events, surgical site infection, neurovascular injury, and mortality). RESULTS: There were 24 males and 16 females, with an average age of 52.2 years (range, 24-77). Finally, a total of 200 screws were successfully inserted in these patients, including fifteen patients with four pedicle screws, four patients with six screws, three patients with eight screws in traditional method group, and 12 patients with four pedicle screws, two patients with six screws, four patients with eight screws in snake-eye method group. Patient demographic and comparison of two surgery methods are shown in Tables 1 and 2. The data baselines of the two groups were comparable because no impact of the two groups on population characteristics was demonstrated in the presented experiment. Also, we noticed that time and accuracy of the two groups were different with statistical significance at the level of P = 0.05. We observed that immediate (within 30 days after surgery) postoperative complications, including pulmonary embolism (PE), surgical site infection (SSI), neurovascular injury (NI), and mortality, in the two groups did not differ. CONCLUSION: This study highlights a safe and effective technique for pedicle screw placement in cervicothoracic spine named snake-eye method, and this technique may be particularly useful in emergency conditions with limited resources.