Aslan Adnan, Elpek Ozlem
Department of Pediatric Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
Surg Today. 2009;39(8):689-94. doi: 10.1007/s00595-009-3948-2. Epub 2009 Jul 29.
The aim was to evaluate the efficacy of a pedicled gastric seromuscular flap for the closure of a large duodenal defect.
A large defect of the second duodenal part was repaired by a gastric seromuscular flap. Of 35 rats, 9 rats were euthanized at 2 weeks, 12 rats at 2 months, and 14 rats at 4 months for the histopathological evaluation of the patch and normal duodenum (control) adjacent to the patch.
All rats survived. The patch was completely covered by neomucosa in all of the 4-month rats, and in 8 of the 12 2-month rats. The villous height of the neomucosa was significantly higher in the 4-month rats in comparison to the other rats (P < 0.001). However, a normal duodenum had higher villi than in that of the patches (P < 0.001). The crypt density of the neomucosa was significantly increased in the 4-month rats in comparison to the 2-week and the 2-month rats (P < 0.001 and P < 0.05 group, respectively). The crypt density was higher in the controls than in the neomucosa covered patch of the 2-week and the 2-month rats (P < 0.001 and P < 0.05, respectively). The crypt depth of the neomucosa increased significantly in the 4-month rats and in the controls versus the 2-week rats (P < 0.05).
The new mucosal barrier overlaying the patch appeared to be satisfactory. This technique, which has not been described previously, is likely to be useful for the repair of the large duodenal defect.
评估带蒂胃浆肌瓣修复十二指肠大缺损的疗效。
采用胃浆肌瓣修复十二指肠第二部大缺损。35只大鼠中，9只在2周时安乐死，12只在2个月时安乐死，14只在4个月时安乐死，用于对补片及补片相邻的正常十二指肠（对照）进行组织病理学评估。
所有大鼠均存活。在所有4个月龄的大鼠以及12只2个月龄大鼠中的8只中，补片完全被新生黏膜覆盖。与其他大鼠相比，4个月龄大鼠新生黏膜的绒毛高度显著更高（P < 0.001）。然而，正常十二指肠的绒毛比补片处更高（P < 0.001）。与2周龄和2个月龄大鼠相比，4个月龄大鼠新生黏膜的隐窝密度显著增加（分别为P < 0.001和P < 0.05组）。2周龄和2个月龄大鼠补片处新生黏膜覆盖区域的隐窝密度低于对照组（分别为P < 0.001和P < 0.05）。与2周龄大鼠相比，4个月龄大鼠及对照组新生黏膜的隐窝深度显著增加（P < 0.05）。
补片上覆盖的新黏膜屏障似乎令人满意。这种此前未被描述过的技术可能对修复十二指肠大缺损有用。
