title: Clinical Application of an Original Vascular Anastomosis: A Clinical Multicenter Study.
abstract: OBJECTIVE
  Vascular anastomosis is the most important technical step required for the possibility of free tissue transfer, and mismatch of the donor and recipient vessel size is the most common surgical challenge. As recent reports have described a new method (Ren anastomosis) to resolve this challenge, the goal of this study was to assess these newly described microvascular anastomosis methods.
  
  
  METHODS
  The study was conducted at 2 institutes in China in different periods. Patients were recruited from the Second Xiangya Hospital between February and May 2013 and from the Shanghai Ninth People's Hospital between March and May 2015. All patients who participated in this study needed free flaps for oral and maxillofacial defects. Patients were divided into the experimental group and the control group. In the experimental group, isometric double-notch end-in-end microvascular anastomosis (Ren anastomosis) was performed, whereas end-to-end anastomosis was performed in the control group. Statistical differences were assessed by use of χ2and t tests.
  
  
  RESULTS
  A total of 148 patients (108 men and 40 women) were treated over the course of this study. There was a statistically significant difference (P < .001) in the operation time for the microscopic artery anastomosis between the experimental group (70 cases; 5.6 ± 1.8 minutes) and the control group (78 cases; 14.6 ± 3.7 minutes). In each group, 1 case of artery compromise was observed.
  
  
  CONCLUSIONS
  The Ren anastomosis was time-saving, straightforward, efficient, and easy to learn, with a high patency rate.
authors.affiliation: Resident, Department of Oral and Maxillofacial & Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, China. Electronic address: zhenhuren@126.com.
authors.forename: Zhen-Hu
authors.initials: ZH
authors.lastname: Ren
authors.affiliation: Department Head, Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Han-Jiang
authors.initials: HJ
authors.lastname: Wu
authors.affiliation: Professor, Department of Oral and Maxillofacial & Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Ji
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Fellow, Department of Oral and Maxillofacial & Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Gokavarapu
authors.affiliation: Department Head, Department of Oral and Maxillofacial & Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: zhangcp9th@hotmail.com.
authors.forename: Chen-Ping
authors.initials: CP
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001160:Arterioles / Q000601:surgery; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000379:methods*