Gade J, Qvortrup K, Andersen C B, Olsen P S
Department of Cardiothoracic Surgery, Rigshospitalet, Denmark.
Ann Thorac Surg. 2001 Jan;71(1):332-6. doi: 10.1016/s0003-4975(00)02129-9.
The bronchial artery may be vital to the bronchi and lung parenchyma, but results of lung transplantation have raised doubts. This study was performed to examine the effect of bronchial arterial devascularization on bronchial morphology after bronchial transsection and reanastomosis.
In 6 pigs (study group), the left main bronchus was transsected, reanastomosed, and devascularized. Six control pigs had the same operation without devascularization. After 1 week, bronchial arterial angiography was performed, and specimens were examined with conventional histology and scanning electron microscopy.
Histology showed significant changes (inflammation, edema, and fibrosis) in bronchi and lung parenchyma of the study group compared with the unoperated side (p = 0.028) and with the control group (p = 0.050). Scanning electron microscopy showed significant ciliary denudation in the study group's left bronchus compared with the unoperated side (p = 0.043) and with the control group (p = 0.0071).
The loss of cilia of the bronchial epithelium and the occurrence of inflammation, edema, and fibrosis in bronchi and lung parenchyma 1 week postoperatively were significantly related to the absence of the bronchial arterial circulation.
支气管动脉对支气管和肺实质可能至关重要,但肺移植的结果引发了质疑。本研究旨在探讨支气管横断与再吻合术后支气管动脉血运阻断对支气管形态的影响。
6头猪(研究组),横断左主支气管,再行吻合,并阻断其血运。6头对照猪行相同手术但不阻断血运。1周后,行支气管动脉血管造影,并对标本进行常规组织学和扫描电子显微镜检查。
组织学检查显示,与未手术侧相比(p = 0.028)及与对照组相比(p = 0.050),研究组支气管和肺实质有显著变化(炎症、水肿和纤维化)。扫描电子显微镜检查显示,与未手术侧相比(p = 0.043)及与对照组相比(p = 0.0071),研究组左支气管有显著的纤毛剥脱。
术后1周支气管上皮纤毛缺失以及支气管和肺实质出现炎症、水肿和纤维化与支气管动脉循环缺失显著相关。