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既往照射对显微外科吻合血管血栓形成的影响:大鼠的一项临床前研究

Effect of Previous Irradiation on Vascular Thrombosis of Microsurgical Anastomosis: A Preclinical Study in Rats.

作者信息

Barrera-Ochoa Sergi, Gallardo-Calero Irene, López-Fernández Alba, Romagosa Cleofe, Vergés Ramona, Aguirre-Canyadell Marius, Soldado Francisco, Velez Roberto

机构信息

Orthopedic Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hand and Microsurgery Unit, ICATME, Hospital Universitari Quiron-Dexeus-Grupo Quirónsalud, Barcelona, Spain; Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Pathology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Radiotherapy Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; and Pediatric Upper Extremity Surgery and Microsurgery Department, Hospital Universitari Sant Joan de Déu, Barcelona, Spain.

出版信息

Plast Reconstr Surg Glob Open. 2016 Nov 23;4(11):e1073. doi: 10.1097/GOX.0000000000001073. eCollection 2016 Nov.

Abstract

BACKGROUND

The objective of the present investigation was to compare the effect of neoadjuvant irradiation on the microvascular anastomosis in cervical bundle using an experimental model in rats.

METHODS

One hundred forty male Sprague-Dawley rats were allocated into 4 groups: group I, control, arterial microanastomosis; group II, control, venous microanastomosis; group III, arterial microanastomosis with previous irradiation (20 Gy); and group IV, venous microanastomosis with previous irradiation (20 Gy). Clinical parameters, technical values of anastomosis, patency, and histopathological parameters were evaluated.

RESULTS

Irradiated groups (III and IV) and vein anastomosis groups (II and IV) showed significantly increased technical difficulties. Group IV showed significantly reduced patency rates (7/35) when compared with the control group (0/35). Radiotherapy significantly decreased the patency rates of the vein (7/35) when compared with the artery (1/35). Groups III and IV showed significantly reduced number of endothelial cells and also showed the presence of intimal thickening and adventitial fibrosis as compared with the control group.

CONCLUSION

Neoadjuvant radiotherapy reduces the viability of the venous anastomosis in a preclinical rat model with a significant increase in the incidence of vein thrombosis.

摘要

背景

本研究的目的是使用大鼠实验模型比较新辅助放疗对颈丛微血管吻合的影响。

方法

140只雄性Sprague-Dawley大鼠被分为4组:I组,对照组,动脉微血管吻合;II组,对照组,静脉微血管吻合;III组,先前接受20 Gy照射后的动脉微血管吻合;IV组,先前接受20 Gy照射后的静脉微血管吻合。评估临床参数、吻合的技术值、通畅情况和组织病理学参数。

结果

照射组(III组和IV组)和静脉吻合组(II组和IV组)显示技术难度显著增加。与对照组(0/35)相比,IV组的通畅率显著降低(7/35)。与动脉(1/35)相比,放疗显著降低了静脉的通畅率(7/35)。与对照组相比,III组和IV组的内皮细胞数量显著减少,还出现了内膜增厚和外膜纤维化。

结论

在临床前大鼠模型中,新辅助放疗降低了静脉吻合的存活率,静脉血栓形成的发生率显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78e4/5142475/6ca66c9d4cd8/gox-4-e1073-g001.jpg

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