Growth of tracheal autografts in puppies
Tóm tắt
The growth of tracheal autografts and the patency of anastomotic regions were studied in 11 mongrel puppies (2.5-4 months of age, 1.9–4.3kg in weight). Thoracic tracheal autotransplantation of 7 cartilage rings was performed. The tracheal autografts and anastomotic regions were covered with an omental pedicle flap to facilitate revascularization. Seven of the 11 dogs were evaluated for 12 months. The cross-sectional area of the lumen at the center of the tracheal autograft, as measured by thoracic computed tomography (CT), showed a significant increase from 0.37 ± 0.11cm2 to 1.13 ± 0.44cm2 after 12 months (P < 0.05). At 12 months postoperatively, all of the experimental dogs were killed, their entire tracheas were resected, and the cross-sectional areas of the anastomosis on the proximal and distal sides were measured. The cross-sectional areas at sites 5mm apart from both anastomoses in the ungrafted trachea were measured as controls. The percent cross-sectional area (%CSA) showed good values of 67.2% ± 19.6% on the proximal side and 85.1% ±12.6% on the distal side. The tracheal autografts appeared both visually and histologically viable 12 months postoperatively. This study was able to demonstrate the growth potential of the tracheal autograft in a growing puppy model.
Tài liệu tham khảo
Moriyama S, Shimizu N, Teramoto S (1989) Experimental tracheal allotransplantation using omentopexy. Transplant Proc 21:2596–2600
Messineo A, Filler RM, Bahoric B, Smith C, Bahoric A (1991) Successful tracheal autotransplantation with a vascularized omental flap. J Pediatric Surg 26:1296–1300
Takahashi H, Hohjo Y, Kimura S (1989) The surgical treatment of congenital tracheal stenosis -A report of two cases. Jpn J Surg 19:358–362
Benjamin B, Pitken J, Cohen D (1981) Congenital tracheal stenosis. Ann Otol Rhinol Laryngol 90:364–371
Nakayama DK, Harrison MR, de Lorimier AA, Brasch RC, Fishman NH (1982) Reconstructive surgery for obstructing lesions of the intrathoracic trachea in infants and small children. J Pediatr Surg 17:854–868
Fin SH, Friedberg J, Williams WG, Rearon B, Barker GA, Mancer K (1982) Tracheoplasty-A new operation for complete cogenital tracheal stenosis. J Pediatr Surg 17:872–878
Idriss FS, Deleon SY, Ilbawi MN, Gerson CR, Tucker GF, Holinger L (1984) Tracheoplasty with pericardial patch for extensive tracheal stenosis in infants and children. J Thorac Cardiovasc Surg 88:527–536
Cohen RC, Filler RM, Konuma K (1985) The successful reconstruction of thoracic tracheal defects with free periosteal grafts. J Pediatr Surg 20:852–858
Akl BF, Yabek SM, Berman W (1984) Total tracheal reconstruction in a three-month-old infant. J Thorac Cardiovasc Surg 87:543–546
Tsugawa C, Kimura K, Muraji T, Nishijima E, Matsumoto Y, Murata H (1988) Congenital stenosis involving a long segment of the trachea: Further experience in reconstructive surgery. J Pediatr Surg 23:471–475
Okumura N, Nakamura T, Natsume T, Shimizu Y, Ikada Y (1991) Experimental study of a new tracheal prosthesis made from collagen-grafted mesh. ASAIO Trans 37:317–319
Spinazzola AJ, Graziano JL, Neville WE (1969) Experimental reconstruction of the tracheal carina. J Thorac Cardiovasc Surg 58:1–13
Neville WE, Bolanowski PJP, Soltanzadeh H (1976) Homograft replacement of the trachea using immunosuppression. J Thorac Cardiovasc Surg 72:596–601
Alonso WA, Bridger GP, Bordley JE (1972) Tracheal transplantation in dog. Laryngoscope 82:204–209
Balderman SC, Weinblatt G (1987) Tracheal autograft revascularization. J Thorac Cardiovasc Surg 94:434–441
Friedman E, Perez-Atayde AR, Silvera M, Jonas RA (1990) Growth of tracheal anastomosis in lambs. J Thorac Cardiovasc Surg 100:188–193
McKeown P, Tsuboi H, Togo T, Thomas R, Tuck R, Gordon D (1991) Growth of tracheal anastomoses: Advantage of absorbable interrupted sutures. Ann Thorac Surg 51:636–641