OBJECTIVE: To review the methods of end-to-side anastomosis in repair of peripheral nerve injury and to analyze the difficulty faced. METHODS: By index of recent literature, the kind of experimental model, observation criteria and the clinical data were collected and analyzed. RESULTS: For different methods of end-to-side anastomosis in repair of peripheral nerve defect, the clinical outcomes were reported differently. The clinical application was fewer. There was lack of case summary and assessment criteria. CONCLUSION: The superiority of end-to-side anastomosis made it necessary to further study the mechanism and improvement of quality.
In order to observe the collateral sprouting capacity of the nerve trunk after end-to-side anastomosis, a window was made on the epineurim of the donor nerve through which the result of the end-to-end anastomosis of nerves could be compared. Sixteen SD rats were chosen and divided into 4 groups randomly. Group 1, the peroneal nerve was severed, the epineurium of the tibial nerve was fenestrated and sutured the peroneal stump with the tibial nerve by end-to-side neurorrhaphy. Group 2, operative procedures were almost the same as that of Group 1, but no fenestration on the epineurium was done. Group 3, the distal peroneal nerve stump was sutured in paralell with the tibial nerve without fenestration on the tibial nerve and Group 4, severed the peroneal nerve and sutured the stumps by end-to-end anastomosis immediately. The peroneal function index(PFI) and acetylcholine transferase (ChAT) activity were assessed and the histological examination was performed in all rats. The results showed: between group 1 and 2, there was no difference in PFI and ChAT activity (P gt; 0.05). The existence of collateral sprouting in all groups was proved by histological examination. Even in Group 3, there were plenty of nerve fibers turned into tiny myelined nerve fibers through collateral sprouting. But the ChAT activity in Group 1 was only two thirds of that in Group 4. It was suggested that the epineurial sheath did not influence the collateral sprouting of the nerve.