Kitagami H, Takahashi T, Watanabe S, Suzuki O, Morikawa T, Okushiba S, Katoh H
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Ann Thorac Surg. 1998 Nov;66(5):1777-81. doi: 10.1016/s0003-4975(98)00775-9.
We evaluated the efficacy of tracheal patch reconstruction with a covered expandable metallic stent (EMS) with omentoplasty.
After resecting the right half of the circumferential wall of two tracheal rings in adult beagle dogs, we inserted a covered EMS to reconstruct the defect interiorly. Then, through laparotomy, we made an omental pedicle flap and wrapped it around the EMS-interposed area. For comparison with the group without omentoplasty, we periodically examined the healing process macroscopically and histologically.
Bronchofiberscopic observations revealed that incorporation of the covered EMS progressed with the passage of time and tracheal luminal patency was maintained well in both groups. However, polyplike granulation developed gradually at both ends of the EMS. Histologically, epithelium was regenerated in the patched area 4 weeks postoperatively and the area was covered with pseudostratified ciliated epithelium at 12 weeks postoperatively. Quantitative analysis of the macroscopic and histologic findings showed that the inflammatory polyps were reduced and epithelialization was promoted in the group with omentoplasty.
Tracheal patch reconstruction with a covered EMS, when combined with omentoplasty, promoted early epithelial regeneration and suppressed the development of inflammatory polyps.
我们评估了带覆膜可扩张金属支架（EMS）并联合网膜成形术进行气管补片重建的疗效。
在成年比格犬中切除两个气管环周壁的右半部分后，我们置入一个带覆膜的EMS在内部重建缺损。然后，通过剖腹术制作一个网膜蒂瓣并将其包裹在置入EMS的区域周围。为了与未行网膜成形术的组进行比较，我们定期从宏观和组织学上检查愈合过程。
支气管纤维镜观察显示，带覆膜EMS的整合随时间推移而进展，两组的气管腔通畅性均保持良好。然而，EMS两端逐渐出现息肉样肉芽组织。组织学上，术后4周补片区域有上皮再生，术后12周该区域被假复层纤毛上皮覆盖。对宏观和组织学结果的定量分析表明，网膜成形术组的炎性息肉减少，上皮化得到促进。
带覆膜EMS进行气管补片重建并联合网膜成形术时，可促进早期上皮再生并抑制炎性息肉的形成。
