10．動脈吻合法（大動脈，中動脈，解離血管・人工血管を含む）

Technique of Arterial Anastomosis

血管吻合において重要な点は，確実な縫合による吻合と，血管内皮の抗血栓機構を障害しないことである．縫合が不確実であると，吻合部からの出血や術後の仮性瘤形成の原因となる．また抗血栓機能の障害により血栓形成による吻合部の早期閉塞や，内膜肥厚を生じ吻合部狭窄の原因となる．それらを防ぐためには，吻合部血管の剝離を適切に行い，血管遮断時や吻合操作時の内膜の障害を最小限にとどめる必要がある．吻合部への過度の緊張も狭窄の一因であり，適切な吻合口の形成と，吻合法の選択が重要となってくる．

The important point in vascular anastomosis is anastomosis with a secure suture and prevention of thrombosis. Uncertainty in sutures can cause bleeding from the anastomotic site and post operative pseudoaneurysm formation. In addition, the failure of the antithrombotic function causes early occlusion of the anastomotic site due to thrombus formation, causing intimal thickening and causing stenosis of the anastomotic site. Vascular anastomosis must be performed with attention to the property and site of the blood vessel, the method of graft formation, and the procedure of suturing. Training is required for fast and accurate sutures, and it is also important to conduct off the job training to efficiently improve your proficiency.