Reconstruction of Large Defects in the Oropharynx with a Revascularized Intestinal Graft: An Experimental and Clinical Report
Reconstruction of Large Defects in the Oropharynx with a Revascularized Intestinal Graft: An Experimental and Clinical Report
复制标题
用血运重建的肠移植物重建口咽大缺损：实验和临床报告
DOI：
10.1097/00006534-198403000-00001
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发表时间：
1984
影响因子：
3.6
通讯作者：
R. Wagner
中科院分区：
文献类型：
--
作者：
J. Reuther;H. Steinau;R. Wagner
我们对六只带有游离血运重建空肠环用于口腔内衬的杂种狗进行的实验研究表明，小肠粘膜在临床和组织学上具有功能适应。尽管移植后1年，70%或更多的移植物表面仍然是小肠粘膜，但绒毛变平和加宽，产生了满足口咽条件的上皮层。在30个随访时间超过4年的临床病例中，我们的实验经验得到了证实。在口咽部进行广泛的消融手术后，采用游离血运重建的空肠袢结合下颌置换进行初次重建具有一些显着的优点： 移植物不存在疤痕硬结。产生粘液。移植物的灵活性和几乎无限的移植物供应即使在困难的解剖部位也能实现令人满意的重建。肠系膜脂肪组织是长期软组织损失的良好移植材料。由于血液供应充足且浆膜迅速凝集，伤口愈合良好。长血管蒂提供除切除区域之外的血运重建，这在辐射病例中很重要。常温缺血 2 小时后粘液产生减少以及下颌置换的解剖重建使得气管造口术不再必要。
Our experimental investigation in six mongrel dogs with free revascularized jejunal loop for intraoral lining shows functional adaptation of the small bowel mucosa clinically and histologically. Although 1 year after transplantation 70 percent or more of the graft's surface remains small bowel mucosa, the flattening and widening of the villi produces an epithelial layer that satisfies the conditions of the oropharynx. In 30 clinical cases with a follow-up period of over 4 years our experimental experience is confirmed. After extensive ablative surgery in the oropharynx, primary reconstruction with free revascularized jejunal loop in combination with mandibular replacement has some significant advantages: There is no cicatricial induration of the graft. Mucus production occurs. Flexibility of the grafts and almost unlimited transplant supply lead to satisfying reconstruction even in difficult anatomic sites. Mesenteric fat tissue serves as good transplant material for extended soft-tissue loss. There is good wound healing, owing to abundant blood supply and prompt agglutination of the serosa. The long vascular pedicle provides revascularization apart from the resection area, which is important in irradiated cases. Decreased mucus production after 2 hours of normothermic ischemia and the anatomic reconstruction of mandibular replacement make tracheostomy not necessary.