自体肺组织瓣修补食管壁部分缺损的实验研究

Replacement of partial esophageal defect with pulmonary tissue with vascular pedicle

目的 探讨自体肺组织瓣修补食管壁部分缺损的可行性。方法 实验选用 12只成年杂种犬 ,将其右肺中叶制成肺组织瓣 ,修补相应部位的全层食管壁缺损 ,缺损纵行长 40mm ,环 1 2～ 2 3管腔。观察术后其进食情况 ,并行组织学检查。结果 定期处死实验犬 ,组织学发现食管缺损处有新生的粘膜上皮形成。存活犬均能经口进食。结论 应用肺组织瓣作为食管修补物 ,修补食管壁的部分缺损是可行的。

Objective: The purpose of our experiment is to use new type esophageal prosthesis, which is pulmonary tissue with vascular pedicle, to repair the partial esophageal defect. Methods: Twelve adult mongrel dogs were used for the study. Middle lobar bronchus of right lung was ligated and incised, so the pulmonary tissue with vascular pedicle was made. A 4 cm long and 1/2～2/3 circled esophageal wall, and full-thickness defect was created. The defect was patched by pulmonary tissue with vascular pedicle. Results: Seven dogs were put to death at planned times after the reconstructive operation. One dog is still alive without any problems for more than 12 months. One dog survived 38 days and then died of chronic empyema. The other three dogs died of anastomotic leak at 5～7 days after operation. The living dogs could be fed orally at seventh day after operation. Epithelization was found in the luminal surface of the defect. Conclusion: It was feasible that the partial esophageal defect was replaced by pulmonary tissue with vascular pedicle.