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用于累及胸主动脉的食管癌手术的主动脉覆膜支架的评估:实验研究

Evaluation of an aortic stent graft for use in surgery on esophageal cancer involving the thoracic aorta: experimental study.

作者信息

Sasahara Hiroko, Sueyoshi Susumu, Tanaka Toshiaki, Fujita Hiromasa, Shirouzu Kazuo

机构信息

Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.

出版信息

Jpn J Thorac Cardiovasc Surg. 2004 May;52(5):231-9. doi: 10.1007/s11748-004-0116-x.

Abstract

OBJECTIVE

The purpose of this experimental study was to investigate whether aortic stent grafting can be applied to the treatment of an esophageal cancer involving the thoracic aorta.

METHODS

The canine thoracic aorta was partially resected without aorta being clamped after emplacement of an endovascular stent graft. Study I; The aortic whole layer of 1 cm in length and 1/4 of the circumference was resected and was covered by a free fascia patch of the abdominal rectal muscle immediately after stent graft placement. Study II; The aortic adventitia and the outer half of the media of the same size was resected on day 3, 7, 14, 21, and on day 28, after the stent graft placement. The resected portion was covered by the free fascia patch in half experimental dogs, and was uncovered in the others. Study III; The aortic adventitia and the outer half of the media of 1 cm in length and 1/2 of the circumference was resected and was uncovered on day 7 after stent graft placement. Histological examinations were performed on day 28 and at one year after aortic resection.

RESULTS

The aortic wall could be resected in all cases with no complication, except in resection of 1/2 the circumference where the aorta had become narrow. There was no difference in healing of the resected portion of the aorta between with and without fascia covering.

CONCLUSION

An aortic endovascular stent graft could be applied to surgery for an esophageal cancer involving the aorta.

摘要

目的

本实验研究旨在探讨主动脉覆膜支架植入术是否可应用于治疗累及胸主动脉的食管癌。

方法

在植入血管内覆膜支架后,在不夹闭主动脉的情况下对犬胸主动脉进行部分切除。研究I:切除长度为1 cm、周长为1/4的主动脉全层,在植入覆膜支架后立即用腹直肌游离筋膜片覆盖。研究II:在植入覆膜支架后的第3天、第7天、第14天、第21天和第28天,切除相同大小的主动脉外膜和中膜的外半层。在一半实验犬中,切除部分用游离筋膜片覆盖,另一半不覆盖。研究III:切除长度为1 cm、周长为1/2的主动脉外膜和中膜的外半层,并在植入覆膜支架后的第7天不进行覆盖。在主动脉切除后的第28天和1年进行组织学检查。

结果

除切除周长的1/2导致主动脉变窄外,所有病例的主动脉壁均可切除且无并发症。主动脉切除部分的愈合情况在有筋膜覆盖和无筋膜覆盖之间没有差异。

结论

主动脉血管内覆膜支架可应用于累及主动脉的食管癌手术。

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