title: Growing cava vein anastomosis: comparison of cross-clamping and suture times using VCS metallic clips, interrupted nonabsorbable, or continuous absorbable suturing techniques.
abstract: BACKGROUND
  The latest generation in titanium clip application systems, the AnastoClip Vessel Closure System (VCS; LeMaitre Vascular, Burlington, MA), allows surgeons to perform vascular anastomosis more easily and faster than conventional sutures. This system may become the option of choice for vascular reconstruction in pediatric surgery where, as in the case transplant surgery, decreasing vascular occlusion times may influence outcome. The aim of this study was to determine whether VCS metallic clips would allow shorter anastomosis times than conventional interrupted polypropylene or running polyglycolic acid suturing in end-to-end anastomosis performed in the abdominal cava of young pigs.
  
  
  METHODS
  Thirty-two domestic swine, 45 days old, were used for this study. All animals were subjected to an end-to-end anastomosis in the abdominal cava.
  
  
  RESULTS
  VCS clips are easier to use for the surgeon, significantly decreasing cross-clamping time in caval anastomosis (VCS 10.33 ± 1.75 min vs. interrupted polypropylene sutures 46.00 ± 6.16 min vs. continuous polyglycolic acid sutures 18.16 ± 1.47 min).
  
  
  CONCLUSIONS
  VCS clips significantly decrease the time needed for performing an end-to-end anastomosis in the abdominal cava, decreasing cross-clamping time when compared to interrupted polypropylene or running polyglycolic acid sutures.
authors.affiliation: Microsurgery Department, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain. mccalles@ccmijesususon.com
authors.forename: Mari Carmen
authors.initials: MC
authors.lastname: Calles-Vázquez
authors.forename: Elena
authors.initials: E
authors.lastname: Abellán Rubio
authors.forename: Verónica Crisóstomo
authors.initials: VC
authors.lastname: Ayala
authors.forename: Jesús
authors.initials: J
authors.lastname: Usón Gargallo
authors.forename: Francisco Miguel
authors.initials: FM
authors.lastname: Sánchez Margallo
mesh_terms: D020341:Absorbable Implants; D000367:Age Factors; D000714:Anastomosis, Surgical; D000818:Animals; D003250:Constriction; D004867:Equipment Design; D008297:Male; D008670:Metals; D023421:Models, Animal; D011100:Polyglycolic Acid; D011126:Polypropylenes; D013525:Surgical Instruments; D034421:Sus scrofa; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013537:Sutures; D013647:Task Performance and Analysis; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D014684:Venae Cavae / Q000254:growth & development / Q000601:surgery*
chemical_list: D008670:Metals; D011126:Polypropylenes; D011100:Polyglycolic Acid