肺组织修补胸内气管不规则缺损的新术式研究

New Operational Study on Reconstruction of Intrathoracic Irregular Defect Trachea With Pulmonary Flap

目的 :探索应用自体带血运的肺组织瓣修补胸内气管不规则缺损的手术新方法 ,为临床应用提供动物实验依据。方法 :将 12例实验犬的气管进行不同侧面的不规则切除 ,缺损区域置入管型金属网架支撑 ,缺损面用自体带血运的肺组织瓣覆盖、缝闭。结果 :2例实验犬术后 1周内死亡 ,不同时段处死 8例 ,2例仍存活者 ,最长达5 3周。病理显示吻合口愈合良好 ,有新生粘膜上皮爬行。结论 :应用自体带血运的肺组织瓣修补胸内气管不规则缺损是气管外科的一种创新术式 ,肺组织瓣取材方便 ,便于操作 ,可以作为胸内气管缺损的修补材料。

Objective: Our purpose was to find a new technique for repairing intrathoracic trachea irregular defect with vascularized pulmonary flap, so as to provide animal experimental foundation for clinics. Methods: After irregularly resecting the walls of different sides of intrathoracic trachea in 12 adult mongrel dogs, we inserted an alloy stent to reconstruct the defect internally. Then we made a vascularized pulmonary flap and wrapped it around the stent interposed area. Results: After the operation, 2 dogs died within one week, 10 dogs had an uneventful postoperative course until they were killed, and 2 survived for more than 53 weeks. Histopathology examination showed the regenerated epithelium lining the prosthetic lumen and no significant granulomatous tissue appearing at the anastomic site. Conclusion: Using autologous pulmonary flap with vascular pedicle to repair irregular defect of intrathoracic trachea is a new technique for trachea surgery. Furthermore, pulmonary flap is promising and convenient material for tracheal reconstruction.