Background: In end-to-side vessel-anastomoses, a side fenestration should be made by a slit incision or partial excision of the vessel wall. However, a slit incision might restrict blood flow across the anastomosis, and a partial vessel wall excision using micro-scissors may be time-consuming and result in irregular edges, which may weaken the vessel wall and cause flow disturbances. We used a biopsy punch for end-to-side anastomosis, and obtained satisfactory results.

Methods: Between September 2015 and August 2017, 27 end-to-side anastomoses using punch biopsies were performed. Two vessel clamps were applied to the recipient vessel proximal and distal to the point planned for the side anastomosis. The flap side vessel size was measured, and an appropriately sized punch was selected. The clamped recipient vessel was supported by a wooden tongue depressor and the punch was applied to the vessel wall. An end-to-side anastomosis was performed in the usual manner, and immediate patency was tested with a refill test.

Results: The vessel patency rate was 96 percent. The mean arteriotomy or venotomy time was 65 s and entire anastomosis procedure time was 1065 s. Both the vessel preparation and the micro-anastomosis procedure times were shorter than those of the conventional procedure group with statistical significance. (p < .05) There was only one case of venous failure by deep vein thrombosis – and it was resolved with thrombectomy and re-anastomosis.

Conclusion: Use of a biopsy punch in end-to-side anastomosis can offer a uniform circular edge and reduce operating time.

背景：在端对端血管吻合术中，应通过切开切口或部分切除血管壁进行开窗术。但是，狭缝切口可能会限制穿过吻合口的血流，使用微剪刀进行的部分血管壁切除可能很耗时，并且边缘不规则，这可能会削弱血管壁并造成流量干扰。我们使用活检打孔器进行端侧吻合，并获得了满意的结果。

方法： 2015年9月至2017年8月，进行了27次使用穿孔活检的端对端吻合术。将两个血管夹在计划进行侧面吻合的点的近端和远端应用到接受血管。测量襟翼侧血管的大小，并选择适当大小的打孔器。夹紧的接受器血管由木制压舌板支撑，并将打孔器施加到血管壁上。以常规方式进行端侧吻合，并通过笔芯测试对即时通畅性进行测试。

结果：血管通畅率为96％。平均动脉切开术或静脉切开术时间为65 s，整个吻合手术时间为1065 s。血管制备和微吻合手术时间均短于常规手术组，具有统计学意义。（p  <.05）只有1例因深静脉血栓形成而导致的静脉衰竭–并通过血栓切除术和再吻合术得以解决。

结论：在端侧吻合术中使用活检打孔器可提供均匀的圆形边缘并减少手术时间。