Giudicelli R, Le Mee F, Thomas P, Reynaud M, Garbe L, Camillieri S, Badier M, Viard L, Barthélemy A, Auffray J P
Service de Chirurgie Thoracique et des Maladies de l'Oesophage, Hôpital Sainte-Marguerite, Marseille.
Ann Cardiol Angeiol (Paris). 1994 Sep;43(7):380-3.
The authors report an analysis concerning the healing of tracheo-bronchial anastomoses after lung- and heart-lung transplantation. The present study includes 64 anastomoses selected from a total of 80 cases. Sixteen had to be excluded because of early post-operative death; none of these deaths was related to an air-way complication. Bronchial healing was assessed by bronchoscopic follow-up; the appearance of the suture-line was classified according to Couraud's grades. The initial reference was the examination at 2 weeks, which was compared to subsequent follow-up. At the initial assessment, 42 anastomoses were grade 1, 4 were grade II, and 18 were grade III. The subsequent anatomic result was satisfactory for 52 sutures (81%). The complications were malacia in 2 cases, stenoses treated with a stenting device in 4 cases, dehiscence in 6 cases. The duration of ischemia and postoperative mechanical respiratory support, as well as the proximal or distal site of the anastomosis appeared to be of significant prognostic value.
作者报告了一项关于肺移植和心肺移植后气管支气管吻合口愈合情况的分析。本研究包括从80例患者中选取的64个吻合口。16个因术后早期死亡而被排除；这些死亡均与气道并发症无关。通过支气管镜随访评估支气管愈合情况；根据库劳德分级对缝线处外观进行分类。最初的参考是术后2周的检查，并与随后的随访进行比较。在初始评估时，42个吻合口为1级，4个为II级，18个为III级。52个缝线（81%）的后续解剖结果令人满意。并发症包括2例软化，4例用支架装置治疗的狭窄，6例裂开。缺血持续时间、术后机械通气支持以及吻合口的近端或远端位置似乎具有显著的预后价值。
