摘要
目的：探讨累及气管的Ｔ４食管癌切除后气管修复成形术中ＯＢ胶的作用。方法：９头成年杂种猪宰杀后即刻取其完整气道，在气管／支气管上作切开／切除—缝合／修补模型共３６处，比较ＯＢ胶加固前后气管成形处的耐压差；并观察ＯＢ胶的固化过程；总结１５例临床应用经验。结果：ＯＢ胶加固后气管成形处的耐压程度明显高于单纯缝合处：切开缝合处分别为１８．０±５．０ｋＰａ，２．０±０．５ｋＰａ；切除修补处分别为１４．０±３．０ｋＰａ，１．０±０．２ｋＰａ；ＯＢ胶与组织紧密结合形成一固化的半透明膜填堵缝合间隙。临床应用ＯＢ胶加固食管癌切除后气管破口修补１５例，效果良好，无毒副作用，无死亡，无相关并发症发生，近期疗效满意。结论：ＯＢ胶加固累及气道的食管癌切除后气管修补处，方法简单方便、安全可靠、无毒副作用；增加了此手术的安全性，拓宽了食管癌的手术指征。
Aim:Patients with advanced esophageal cancer often have tracheobronchial invasion which causes respiratory distress.This study was designed to detect the effect of monomericbutylcyanoacrylate(OB glue)on reinforcement of airway reconstruction following partial esophagectomy and airwayplasty.Method:(1)Experimental study:Tracheobronchial specimens were taken from 9 pigs.A 1cm longitudinal and transversal incision was made separately on each specimen.The incision was subsequently repaired with Sweet's sutures and then covered by OB glue.Resistance of reconstructed airway to intraluminal pressure was measured before and after using OB glue.(2)Clinical study:Ten patients with airway involvement caused by advanced esophageal cancer underwent partial esophagectomy and esophagogastrostomy.The involved trachea or bronchi were partially resected and repaired with Sweet's suture and OB glue applied locally.Results:(1)Experimental study:Intraluminal resistant pressure of airway incision after repair and local application of OB glue was significantly increased from 2.0±0.5kPa in simple repair specimens to 18.0±5.0kPa(P<0.01)in OB glue series.(2)Clinical study:There were no operative deaths or respiratory complications.Followup ranged from 4 to 26 months.7 patients survived more than 12 months after operation.Conclusion:OB glue is an effective agent for reinforcement of airway repair after en block resection of esophageal cancer and the involve airway.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1998年第2期84-86,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
