Li J, Xu P, Chen H, Yang Z, Zhang Q
Department of Cardiothoracic Surgery, First Hospital of Beijing Medical University, China.
Ann Thorac Surg. 1995 Dec;60(6):1592-6. doi: 10.1016/0003-4975(95)00839-x.
Reconstruction of tracheal defects with tracheal grafts is not practicable clinically because the problem of tracheal graft revascularization has not been solved successfully. We conducted experiments to investigate efficacy of implanting tracheal graft into the greater omentum for revascularization and possibility of adopting staged transplantation procedure for repair of tracheal defect.
Twenty-four mongrel dogs were randomly and equally divided into groups I and II. Six-ring cervical tracheal segments were harvested as autografts. The grafts were wrapped with the omentum and placed into the peritoneal cavity in group I, and reimplanted with omentopexy in group II. Four grafts were examined macroscopically, microscopically, and 35S-autoradiographically on postoperative days 3, 7, and 14, respectively.
Epithelium loss was evident in the mucosas of the grafts except the 4 from group I. Percentages of viable chondrocytes assessed with 35S-autoradiography were significantly higher in tracheal grafts from group I than group II. All tracheal grafts with their own omental pedicles could be brought to any portions of the trachea.
We conclude that prior implantation of tracheal graft in the omentum is beneficial for preservation of its structure, and reconstruction of a tracheal defect with a tracheal graft implanted first into the omentum is feasible.
由于气管移植物的血管再生问题尚未得到成功解决，临床上用气管移植物重建气管缺损是不可行的。我们进行了实验，以研究将气管移植物植入大网膜以实现血管再生的效果，以及采用分期移植手术修复气管缺损的可能性。
24只杂种犬被随机等分为I组和II组。切取六环的颈段气管作为自体移植物。I组将移植物用大网膜包裹后置于腹腔内，II组将移植物重新植入并固定大网膜。分别在术后第3天、第7天和第14天对4个移植物进行大体观察、显微镜检查和35S放射自显影检查。
除I组的4个移植物外，其他移植物的黏膜上皮均有明显缺失。用35S放射自显影评估的I组气管移植物中存活软骨细胞的百分比显著高于II组。所有带有自身网膜蒂的气管移植物均可被带到气管的任何部位。
我们得出结论，预先将气管移植物植入大网膜有利于其结构的保存，并且先用气管移植物植入大网膜再进行气管缺损重建是可行的。
