Histopathologic changes after tracheobronchial reconstruction with costal cartilage graft for congenital tracheal stenosis.
Histopathologic changes after tracheobronchial reconstruction with costal cartilage graft for congenital tracheal stenosis.
复制标题
先天性气管狭窄用肋软骨移植气管支气管重建后的组织病理学变化。
DOI：
10.1053/jpsu.2001.20708
复制
发表时间：
2001
影响因子：
2.4
通讯作者：
A. Okada
中科院分区：
文献类型：
--
作者：
T. Oue;S. Kamata;N. Usui;H. Okuyama;K. Nose;A. Okada
背景/目的
先天性气管狭窄是一种罕见的，危及生命的条件。最近，使用肋软骨移植物扩大管腔的气管成形术已成功用于此类病例。在这项研究中，我们评估了气管成形术后肋软骨移植物的变化。
方法
应用肋软骨补片气管成形术治疗婴幼儿长段先天性气管狭窄18例。本研究包括6例在尸检时获得气管标本的患者。修复时的平均年龄为4.8个月，术后平均时间为7.5个月。评估每例患者的软骨移植物存活率和内层上皮化情况。
结果
手术时移植物的平均宽度和长度为6.3 x 35 mm，尸检时为4.0 x 22 mm。术后移植物体积逐渐缩小，2年后完全被成熟的瘢痕组织所取代。然而，重建部位的直径没有减小。所有病例均发现移植部位的纤毛柱状上皮再上皮化。软骨细胞数量减少，剩余的软骨相当嗜酸性，表明移植物中的退行性过程正在进行。
结论
肋软骨移植物建立了功能性气管腔，并在移植部位发现纤毛柱状上皮的再上皮化。肋软骨移植物仍然是长段先天性气管狭窄婴儿气管重建的重要选择。
BACKGROUND/PURPOSE
Congenital tracheal stenosis is an uncommon, life-threatening condition. Recently, tracheoplasty using costal cartilage grafts to enlarge the lumen was used successfully in such cases. In this study, we evaluated postoperative changes of costal cartilage grafts after tracheoplasty.
METHODS
Costal cartilage patch tracheoplasty was used for surgical correction of long-segment congenital tracheal stenosis in 18 infants. Six patients whose tracheal specimens were obtained at autopsy are included in this study. The mean age at the time of repair was 4.8 months, and the mean period after operation was 7.5 months. Cartilage graft survival and epithelialization of inner layer was evaluated in each case.
RESULTS
The mean width and length of grafts was 6.3 x 35 mm at operation and 4.0 x 22 mm at autopsy. The graft size was diminished gradually after operation and was replaced completely by mature scar tissue 2 years after operation. However, diameter of the reconstructed site was not reduced. Reepithelialization of the graft site with ciliated columnar epithelium was found in every case. Chondrocyte numbers were reduced and remaining cartilage was rather eosinophilic, suggesting that the degenerative process was ongoing in the graft.
CONCLUSIONS
The costal cartilage grafts established a functional tracheal lumen, and reepithelialization with ciliated columnar epithelium was found at the graft site. The costal cartilage grafts continues to be an important option as graft material for tracheal reconstruction in infants with long segment congenital tracheal stenosis.