摘要
目的生物型人工食管重建食管,探索解决术后吻合口瘘及晚期狭窄的途径。方法30只中国杂种犬经右侧开胸切除胸段食管,并以8cm长生物型人工食管进行重建,观察愈合过程。结果30只犬存活率815%(22/27),围手术期存活率933%(28/30)。吻合口瘘发生率67%(2/30)。术后平均288d人工食管脱落,术后60～75d出现不同程度狭窄,13例狭窄经扩张而缓解,5例需放置支架。病理结果显示新生食管由纤维结缔组织构成,其内面覆盖鳞状上皮,上皮下可见血供。结论生物型人工食管植入后,可短暂替代食管,并由机体修复为有上皮组织爬覆的纤维结缔组织新生食管,新生食管的后期狭窄经妥善的内科治疗可缓解,故人工食管可望成为有效的食管重建方式之一;解决植入长度及减轻狭窄是今后研究的重点。
Objective To investigate the methods of solvin g anastomotic fistula and late stric ture after repalcement of the esophagus with biological artificial esophagu s in dog.Methods The 8cm length biological artificial esophagus wa s implanted to 30Chinese mongrels wi th right thoracotomy.Results Twenty-two dogs were survived and th e survival rate was 81.5%(22/27).Twenty-eight dogs survived during the time of 14postoperative days,an d the survival rate was 93.3%(28/30).Anastomosis leakage was found in 2dogs(6.67%),and one died of the pneumonia,no oth er prosthesis relative complicatio n happened.The prosthesis was observed to be taken o ff from the regenerated esophagus ab out 30postoperative days,the midregion stenosis of the regenerated esophagus occurred about 2～3mont hs after implantation,13dogs of regenerated esophagus stenosis were reliefed by the endoscopical ballo on dilation and 5dogs were cured by implanted the esophageal stent.The histology and endoscopical findings showed that the luminal surface of regenerated esophagas was coverd wi th smooth mucosa and the complete epi theliation was observed within3～6months.Conclusions The biological artificial esophagu s is one of safe and effective methods to the reconstrction of esophagus and the l ate stage stenosis of regenerated esophagus can be reliefed by the endoscopical therapy or esophageal stent.It is the key point to choose th e suitable length and ameliorate the stenosis of the prosthesis in the fut ure.
出处
《中华胃肠外科杂志》
CAS
2001年第3期157-160,共4页
Chinese Journal of Gastrointestinal Surgery
