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 Chir. 1993;47(2):99-102.
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 I, 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 post-operative 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例病例中选取的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合线外观进行分类。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个吻合口为I级，4个为II级，18个为III级。52条缝合线（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。
