金属网架外覆肺组织替代气管的动物实验研究

Experimental Research in Dogs Using Alloy Stent Covered With Pulmonary Tissue to Reconstruct Trache

目的 :寻求气管重建的新方法 ,解决较为复杂的长段气管重建问题。方法 :选用杂种成年犬 12只 ,将一叶肺组织脏层胸膜向内翻转缝合成管状内衬记忆合金网架与切除后的气管远近端行端端吻合 ,完成气管重建。结果 :8只实验犬获得存活 ,病理证实吻合口愈合良好 ,术后两周替代物管腔内即有新生上皮爬行。结论 :该实验提出了带血运的肺组织内衬记忆合金网架替代气管这一新方法。为长段气管缺损修补、重建提供了一个有效的新途径。

Objective: Our purpose was to establish a new and physically suitable method for tracheal reconstruction with pulmonary flap lined with elastic alloy stent, especially in the long segment of thoracic tracheal replacement. Methods: Twelve dogs underwent resection of thoracic trachea (4 to 6 cm) and reconstructed with pulmonary flap prostheses. After right thoracotomy through the 4th intercostal space, we resected the right upper bronchus and tied it to make the right upper lobe atelectasis. Then,we turned the pulmonary flap over to make a roll lined with alloy stent anastomosed with the two residual end of trachea. The incised trachea is 4 to 7 cm in length. Results: One dog died from anesthesia accident, 2 died in the immediate postoperative period from anastomotic leakage and pneumoempyema, and 1 died from intrathoracic infection on the 5th postoperative day. The other 8 dogs lived up to 67 days. We found the pulmonary flap healed well with the trachea pathologically. Normal epithelium with cillia were seen on the surface of the lumen near the anastomasis. Conclusion: Tracheal reconstruction with pulmonary flap is a feasible method. Long term effects of this method still need further observation.