摘要
目的 目前国内外少有食管重建成品材料 ,且所报道的动物实验围手术期成活率较低。本研究旨在探讨生物型人工食管应用在犬食管重建术中的可行性。方法 实验采用生物型人工食管 ,30只实验犬为中国杂种犬。切除部分胸段食管后 ,以 8cm长生物型人工食管进行重建 ,观察存活率、进食及愈合过程。结果 30只犬围手术期存活 2 8只 ,存活率为 93.3%。吻合口瘘 2只 ,发生率为 6 .7%。存活 1年者 19只 ,存活率为 79.2 % (19/ 2 4 ,其余 6只按实验方案处死 )。术后平均 2 8.8d人工食管脱落。术后 2 3～ 4 5d及 2个月时有不同程度进食受阻 ,4个月后逐渐缓解。组织学结果显示“新生食管”由纤维结缔组织构成 ,腔面于术后 3～ 6个月完成鳞状上皮爬覆。结论 生物型人工食管用于食管重建 ,周围“新生食管”形成后 ,植入的人工食管脱落 ,鳞状上皮逐渐在腔面爬覆 ,随着“新生食管”的不断塑型 ,其狭窄逐渐缓解。
Objective Currently, little material is available for esophagus reconstruction and the survival rate within perioperative period is low in animal experiments in the literature. This study assesses the feasibility of esophagus reconstruction with biological artificial esophagus in dogs. Methods The biological artificial esophagus and 30 Chinese mongrels were used as experimental materials. Part of the thoracic esophagus of dogs were resected, then 8 cm length biological artificial esophagus were implanted to reconstruct the esophagus. The surviving and eating, as well as healing process were observed. Results Among the 30 dogs, 28 dogs were survived after perioperative period,the survival rate was 93.3%. The anastomotic leakage was found in 2 dogs(6.67%). Nineteen dogs were survived for one year, and the survival rate was 79.2%(19/24, 6 dogs were killed according to the experimental protocol). The average time of exfoliation of biological artificial esophagus was 28.8 days. The dysphagia was occurred 23 to 45 days, and 2 months after operation, however, it can be remitted by itself after 4 months. The histology showed that the regenerated esophagus was consisted of fibrous and connective tissue, and the luminal surface of regenerated esophagus was coverd with squamous epithelium within 3-6 months. Conclusions The “new esophagus” was regenerated after the operation of esophagus reconstruction, and the biological artificial esophagus would exfoliate. While the regenerated esophagus mould, the stenosis was relieved by itself. To solve the exfoliation of artificial esophagus and stenosis after operation is the key for the biological artificial esophagus to be used in clinics.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2003年第3期137-141,共5页
Chinese Journal of Digestion
