放射治疗对犬颈阔肌皮瓣修复食管的影响

Effect of radiotherapy on platysma myocutaneous flap after esophageal reconstruction in dogs

目的观察放射治疗对犬颈阔肌皮瓣修复食管的影响。方法11只健康成年家犬行颈阔肌皮瓣修复食管后,按随机数字表法分为预防放射剂量(4800cGy)、根治性放射剂量(6400cGy)及对照组。观察犬饮食情况、早期放射反应,吻合口通畅情况,活杀后测定吻合口顺应性、肌皮瓣组织生物力学特性、羟脯氨酸含量,光学及电子显微镜观察肌皮瓣结构改变。结果死亡3只,放射治疗两组摄食能力及体质量无显著下降。放射早期食管与皮瓣轻度充血、红肿,皮瓣有少量毛发生长,吻合口无明显狭窄,颈阔肌皮瓣吻合口部顺应性,羟脯氨酸含量以及生物力学特性各组间均无显著差异,病理及超微结构见肌皮瓣胶原排列比颈部伤口皮肤胶原紊乱且较粗大,其余结构无明显改变。结论实验犬颈阔肌皮瓣修复食管后,能够耐受预防及根治剂量的放射治疗。

Objective To explore the effect of radiotherapy on platysma myocutaneous flap （PMF） after esophageal reconstruction in dogs. Methods Eleven healthy adult dogs with PMF imbedding esophagus were randomly divided into three groups： prophylactic radiation dose （4 000 cGy）, radical cure radiation dose （6 400 cGy） and control group. Foodintake, early radiotherapeutic reaction of esophagus and PMF were surveyed, and stoma condition was observed with barium swallow esop before and after radiation, After killing these dogs, we surveyed the compliance of PMF and esophagus, and the vitodynamics characteristics and oxyproline content of PMF. The structural changes of PMF were observed under light and electron microscope respectively. Results Three dogs died. The body weight and foodintake had no statistical difference between two radiotherapeutic groups. In the early days of radiation, mild flare and congestion in esophagoscopy were found both in esophagus and flaps, a little hair growing in flaps. No anastomotic stenosis. No significant deviation was found in the compliance of PMF stoma, vitodynamic characteristics and the oxyproline content of PMF in the three groups of dogs. Light and electron microscopy showed that except that the alignment of PMF collagen was more disordered and larger than cervical skin wounds, no more structural changes was found after radiation. Conclusion Platysma myocutaneous flaps after esophageal reconstruction in dogs might tolerate radiotherapy with usual dose.