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犬小肠黏膜下层作为一种替代性中直径自体动脉移植物。

Submucosa of canine small intestine as an alternative medium-diameter autogenous arterial graft.

作者信息

Baltoyannis G, Mitsis M, Nathanael C, Batsis C, Pappas S, Nastos D, Kappas A M

机构信息

Department ot Surgery, School of Medicine, Ioannina University, Greece.

出版信息

Int Angiol. 2000 Sep;19(3):280-4.

Abstract

BACKGROUND

Small intestinal canine submucosa has been used in previous studies as a large diameter arterial graft and has shown acceptable patency rates. The aim of our experimental study was to assess its effectiveness when it is used as an autogenous medium-sized diameter arterial graft (5-7 mm).

METHODS

Fifteen mongrel dogs were included and underwent laparotomy under general anaesthesia. The mucosa, tunica muscularis and serosa were removed from a resected intestinal segment. The remaining tube, which consisted of the submucosa and the basilar tunica mucosa, represented the experimental graft which was used to replace a proportional gap of the canine infrarenal aorta. Ascertainment of peripheral pulses, measurement of the intra-aortic pressures, aortography and in vivo/in situ observation before the sacrifice of the animals, were the procedures used for verification of the graft's patency.

RESULTS

The resistance to thrombogenicity of the graft was considered satisfactory: nine out of 10 grafts remained patent for postoperative intervals ranging from one day to one year; one graft showed partial obstruction due to a technical perioperative error. The grafts showed also excellent physical characteristics (ease of handling and suturing, blood impermeability and durability), resistance to infection and showed no tendency to develop myointimal hyperplasia.

CONCLUSIONS

Small intestinal canine submucosa showed satisfactory haemodynamic properties, long-term patency and resistance to infection, when used as a medium-diameter arterial substitute.

摘要

背景

在先前的研究中,犬小肠黏膜下层已被用作大口径动脉移植物,并显示出可接受的通畅率。我们的实验研究目的是评估其作为自体中口径动脉移植物(5 - 7毫米)时的有效性。

方法

纳入15只杂种犬,在全身麻醉下进行剖腹手术。从一段切除的肠段中去除黏膜、肌层和浆膜。剩下的由黏膜下层和基底黏膜层组成的管道代表实验性移植物,用于替代犬肾下腹主动脉的一段相应长度的缺口。通过确定外周脉搏、测量主动脉内压力、进行主动脉造影以及在动物处死前进行体内/原位观察等程序来验证移植物的通畅情况。

结果

移植物的抗血栓形成能力被认为是令人满意的:10个移植物中有9个在术后1天至1年的时间段内保持通畅;1个移植物由于围手术期技术失误出现部分阻塞。移植物还表现出优异的物理特性(易于操作和缝合、不透血且耐用)、抗感染能力,并且没有发生肌内膜增生的倾向。

结论

当用作中口径动脉替代物时,犬小肠黏膜下层显示出令人满意的血流动力学特性、长期通畅性和抗感染能力。

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