Giudicelli R, Thomas P, Massard G, Reynaud M, Fuentes P, Noirclerc M
Department of Thoracic Surgery, Hôpital Sainte Marguerite, Marseille, France.
Eur J Cardiothorac Surg. 1993;7(9):453-6. doi: 10.1016/1010-7940(93)90273-e.
The authors report on an analysis concerning the healing of tracheobronchial anastomoses after lung and heart-lung transplantation. The present study includes 64 anastomoses selected from a total of 80. Sixteen were excluded because of early postoperative death; none of these deaths was related to an airway complication. Bronchial healing was assessed with bronchoscopic follow-up; the aspect of the suture line was classified according to the grades of Couraud. The initial reference was the examination at 2 weeks postoperatively, which was compared to subsequent follow-ups. At the initial assessment, 42 anastomoses were grade I, 4 were grade II, and 18 were grade III. The subsequent anatomic result was satisfactory for 52 sutures (81%). The complications observed in the remaining patients were malacia in 2, stenosis treated with a stenting device in 4 and dehiscence in 6. The duration of ischemia and postoperative mechanical respiratory support, as well as the proximal or distal location 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。本研究包括从总共80例吻合口中选取的64例。16例因术后早期死亡被排除；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；缝线部位根据库劳德分级进行分类。最初的参照是术后2周的检查，并与随后的随访进行比较。在初次评估时，42例吻合口为I级，4例为II级，18例为III级。52例缝线（81%）的后续解剖结果令人满意。其余患者观察到的并发症包括2例软化、4例采用支架装置治疗的狭窄和6例裂开。缺血持续时间和术后机械通气支持，以及吻合口的近端或远端位置似乎具有显著的预后价值。
