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[使用带血管蒂回肠移植重建颈段食管(实验研究)]

[Reconstruction of the cervical esophagus using a revascularized ileal graft (experimental study)].

作者信息

Khussar Iu P, Milenin O V, Tiunder E O, Sillakivi T K, Pille A P, Khussar P Iu

出版信息

Vestn Khir Im I I Grek. 1996;155(5):10-4.

PMID:9123744
Abstract

The clinic and histomorphology of the revascularized ileum autograft used for the reconstruction and/or replacing the cervical oesophagus in 76 adult mongrel dogs were examined from the 1st to 372nd postoperative days. In 46% of the cases complete recovery of autografts has been established. In 54% of the cases various complications were noticed-very long ischemia, necrosis and spontaneous detachment of the autografts injury of the superficial (endothelial) layer of blood vessels. Thrombosis of blood vessels, tissue haemorrhage, bleeding of the contact areas, wound infections, stenosis of the tubular autografts, unknown cases of abnormalities and mortality could also take place. There are a so-called split or detached contact within the oesophagus and the ileum graft as well as a lowering and enlargement of the villi, atypical crypts, partial replacement of the epithelium columnar cells with goblet cells, inflammatory lymphocytic infiltration of propria and epithelium, high phagocytic activity of the macrophages. The transplant changes can be more rapid if the defect of the cervical oesophagus is filled with a small intestine patch. At the junction of the morphological picture a strong hypo- and atrophy can be observed as well as the destruction and irritation, complete replacement of the columnar cells with mucous cells. In the so-called resorptive contact typical epitheliocytes have been replaced by a polymorphic cell mass. Acute inflammatory infiltration penetrated regionally all over the transplant. The simple columnar epithelium of the ileus transplant has been replaced by the non-keratinized stratified squamous epithelium.

摘要

对76只成年杂种犬术后1天至372天用于重建和/或替代颈段食管的血管化回肠自体移植组织的临床和组织形态学进行了检查。46%的病例自体移植组织完全恢复。54%的病例出现了各种并发症——自体移植组织缺血时间过长、坏死、自发性脱离、血管表层(内皮)损伤、血管血栓形成、组织出血、接触部位出血、伤口感染、管状自体移植组织狭窄、不明原因的异常情况和死亡。食管和回肠移植物内存在所谓的分离或脱离接触,同时绒毛降低、增大,隐窝不典型,柱状上皮细胞部分被杯状细胞取代,固有层和上皮出现炎性淋巴细胞浸润,巨噬细胞吞噬活性高。如果颈段食管缺损用小肠补片填充,移植组织的变化可能更快。在形态学图像的交界处,可观察到强烈的发育不全和萎缩,以及破坏和刺激,柱状细胞完全被黏液细胞取代。在所谓的吸收性接触中,典型的上皮细胞被多形细胞团取代。急性炎性浸润局部贯穿整个移植组织。回肠移植组织的单层柱状上皮已被非角化复层鳞状上皮取代。

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