A novel method of tracheal anastomosis healing using a single submucosal injection of basic fibroblast growth factor: initial report
A novel method of tracheal anastomosis healing using a single submucosal injection of basic fibroblast growth factor: initial report
复制标题
DOI：
10.1093/ejcts/ezab542
复制
发表时间：
2021-12-16
影响因子：
3.4
通讯作者：
Komura, Makoto
中科院分区：
文献类型：
--
作者：
Yokote, Fumi;Yamauchi, Yoshikane;Komura, Makoto
目的在气管吻合术的技术管理中，需要开发新的、简便的方法来缓解吻合口张力。本研究旨在探讨吻合前一次性注射碱性成纤维细胞生长因子(BFGF)是否能促进气管吻合处软骨再生，以及再生的软骨是否具有加强吻合口的作用。方法新西兰大白兔麻醉后，经颈正中切开暴露气管，切除第10个气管软骨。将兔分为两组：碱性成纤维细胞生长因子组(n=6)和对照组(n=6)。前一组在气管吻合前用27-G针于软骨粘膜下层注射碱性成纤维细胞生长因子(25微克)。4周后处死动物。结果4周龄时，吻合口呈纺锤形，注射部位直径最大，与对照组相比差异有统计学意义。组织学评价显示，在第9~11个气管软骨环之间有软骨组织再生。拉伸试验显示吻合口的应变/应力比显著升高(P=0.035)。I型胶原含量显著降低(P=0.019，P=0.013，P=0.045)。结论一次注射碱性成纤维细胞生长因子可促进兔气管软骨再生，并通过桥接再生的成熟软骨来加强吻合，为气管吻合提供了一种新的创面修复理念。该方法的进一步研究将为气管吻合术的加强提供潜在的临床应用。
OBJECTIVES For the technical management of tracheal anastomosis, developing new and simple methods is required to relieve anastomotic tension. This study aimed to investigate whether basic fibroblast growth factor (bFGF) only once injected immediately before anastomosis promotes cartilage regeneration at the tracheal anastomosis and whether the regenerated cartilage has the effect of reinforcing the anastomosis in a rabbit model.METHODS New Zealand white rabbits were anaesthetized, and the cervical trachea was exposed through a cervical midline incision, followed by resection of the 10th tracheal cartilage. The rabbits were categorized into 2 groups: the bFGF group (n = 6) and the control group (n = 6). In the former group, bFGF (25 mu g) was administered into the submucosal layer of the cartilage using a 27-G needle immediately before tracheal anastomosis. The animals were sacrificed 4 weeks later. Histological, mechanical and biochemical evaluations were performed on this anastomosed trachea.RESULTS At 4 weeks of age, the anastomoses were spindle-shaped and displayed maximum diameter at the injection site compared with those in the control group. Histological evaluation showed that cartilage tissue had regenerated between the 9th and 11th tracheal cartilage rings. Tensile test showed that the anastomoses displayed a significantly high strain/stress ratio (P = 0.035). The collagen type II and glycosaminoglycan levels were significantly increased, and the collagen type I level was significantly decreased (P = 0.019, P = 0.013 and P = 0.045, respectively).CONCLUSIONS A new wound-healing concept of airway anastomosis could be provided by the results that single injection of bFGF regenerated tracheal cartilage in rabbits and strengthened the anastomosis by bridging the regenerated and well-matured cartilage. Further investigation of this method will lead to potential clinical applications for reinforcement of tracheal anastomoses.