Behrend Matthias, Kluge Eva, Schüttler Wolfgang, Klempnauer Jürgen
Klinik für Viszeral- und Transplantationschirurgie, Hannover, Germany.
Laryngoscope. 2002 Feb;112(2):364-9. doi: 10.1097/00005537-200202000-00029.
The objective of our study was to postoperatively examine the mechanical stability under load of tracheal anastomoses over different periods in time and to compare these with native tracheae.
A randomized experimental study on animals.
We performed tracheal anastomoses on sheep with three different suturing techniques and different resection lengths (3, 6, and 9 cm): These anastomoses were subjected to a breaking test at different intervals in vivo (1, 2, 4, 8, and 24 wk) and compared with the tracheae of healthy sheep.
After 1 week in vivo, the anastomosis itself tore off from the remaining trachea under tension, regardless of the suturing technique used and the length of resection. With all animals that survived for a longer period, the trachea broke a greater distance away from the anastomosis. The necessary breaking forces were only minimally lower than those required for breaking healthy tracheae and the difference is statistically insignificant. When all operated tracheae are combined and the forces compared with native tracheae, this reveals that the operated tracheae are significantly more stable (P =.015) and present a lower longitudinal elasticity (P =.004).
During the first postoperative days, the stability under load of tracheal anastomoses is slightly lower than that of healthy trachea. This difference is, however, far from those values that can be measured intraoperatively on tracheal anastomoses. Thus, supplementary measures for the mechanical protection against suture line separation do not seem necessary.
我们研究的目的是在术后不同时间段检查气管吻合口在负荷下的机械稳定性，并将其与正常气管进行比较。
一项动物随机实验研究。
我们采用三种不同的缝合技术和不同的切除长度（3厘米、6厘米和9厘米）对绵羊进行气管吻合术：这些吻合口在体内不同时间间隔（1周、2周、4周、8周和24周）接受断裂试验，并与健康绵羊的气管进行比较。
在体内1周后，无论使用何种缝合技术和切除长度，吻合口本身在张力作用下从剩余气管上撕裂下来。对于所有存活较长时间的动物，气管在距吻合口较远的位置断裂。所需的断裂力仅略低于正常气管断裂所需的力，差异无统计学意义。当将所有手术过的气管合并并将其力量与正常气管进行比较时，结果显示手术过的气管明显更稳定（P = 0.015）且纵向弹性更低（P = 0.004）。
在术后的头几天，气管吻合口在负荷下的稳定性略低于健康气管。然而，这种差异远低于术中可测量的气管吻合口的值。因此，似乎没有必要采取额外措施来机械保护防止缝线处分离。
