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应用戊二醛处理的自体心包补片闭合部分性气管缺损。

Partial Tracheal Defects Closure using Glutaraldehyde-Treated Autologous Pericardium.

机构信息

Department of Thoracic Surgery, Kanazawa University, Kanazawa, Japan.

Department of Cardiovascular Surgery, Kanazawa University, Kanazawa, Japan.

出版信息

Thorac Cardiovasc Surg. 2023 Sep;71(6):490-496. doi: 10.1055/s-0042-1757301. Epub 2022 Oct 10.

Abstract

BACKGROUND

The usefulness of autologous pericardium treated with glutaraldehyde (GA) for tracheal defect closure is unknown. This study preliminarily evaluated whether a GA-treated autologous pericardial graft can effectively close tracheal defects in a beagle model.

METHODS

Defects of 10 mm × 10 mm were created on the trachea of 10 beagles and divided into a GA-treated group ( = 5), with tracheal reconstruction using GA-treated pericardium, and control group ( = 5), using fresh pericardium. Repair sites were evaluated through bronchoscopy and histology. Blood flows on graft were measured using laser Doppler technique on postoperative days (PODs) 0, 4, 7, 14, 28, and 56. Repair sites were histologically evaluated on POD 56. In addition, GA-treated pericardia of three other beagles were histologically evaluated 12 months postoperatively, for long-term follow-up.

RESULTS

All animals survived; none developed anastomotic insufficiency. The mean suturing time and frequency of additional suture were significantly shorter and lower in the GA-treated group than in the control group ( = 0.002, 0.004). All animals in the control group exhibited graft contraction, whereas the GA-treated group healed with most graft residual and reepithelialization in the bronchoscopic and histological findings ( = 0.01, 0.004). Further, all long-term GA-treated pericardia of three beagles were confirmed as residual grafts with reepithelialization, without contraction, at 12 months postoperatively. Blood flows on graft using laser Doppler technique in the GA-treated group were detected at POD 14 or thereafter.

CONCLUSION

GA-treated pericardium was easier to handle and provided favorable scaffolding, without graft contraction, compared with the nontreated pericardium at short- and long-term follow-up.

摘要

背景

用戊二醛(GA)处理的自体心包在气管缺损闭合中的作用尚不清楚。本研究初步评估了 GA 处理的自体心包移植物是否能有效地闭合比格犬模型中的气管缺损。

方法

在 10 只比格犬的气管上创建 10mm×10mm 的缺损,并分为 GA 处理组(n=5),使用 GA 处理的心包膜进行气管重建,和对照组(n=5),使用新鲜心包。通过支气管镜和组织学评估修复部位。在术后第 0、4、7、14、28 和 56 天使用激光多普勒技术测量移植物上的血流。在术后第 56 天对修复部位进行组织学评估。此外,对另外 3 只比格犬的 GA 处理心包进行了术后 12 个月的组织学评估,进行长期随访。

结果

所有动物均存活,无吻合口不足。GA 处理组的平均缝合时间和额外缝合的频率明显短于对照组(=0.002,0.004)。对照组所有动物均出现移植物收缩,而 GA 处理组在支气管镜和组织学检查中显示大部分移植物残留和再上皮化(=0.01,0.004)。此外,在术后 12 个月时,3 只比格犬的所有长期 GA 处理心包均被证实为残留移植物,有再上皮化,无收缩。在 GA 处理组中,使用激光多普勒技术检测到移植物上的血流在术后第 14 天或之后。

结论

与未处理的心包膜相比,GA 处理的心包膜在短期和长期随访中更容易操作,提供了有利的支架,且无移植物收缩。

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