EFFECT OF OMENTAL, INTERCOSTAL, AND INTERNAL MAMMARY ARTERY PEDICLE WRAPS ON BRONCHIAL HEALING
EFFECT OF OMENTAL, INTERCOSTAL, AND INTERNAL MAMMARY ARTERY PEDICLE WRAPS ON BRONCHIAL HEALING
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DOI：
10.1016/0003-4975(90)90303-n
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发表时间：
1990-04-01
影响因子：
4.6
通讯作者：
BROWN, JW
中科院分区：
文献类型：
--
作者：
TURRENTINE, MW;KESLER, KA;BROWN, JW
在肺移植袖状切除术中，必须切断支气管和血管，使远端支气管段缺血，并发生狭窄或裂开。30只杂种犬进行了自体左肺移植。支气管吻合口分别用大网膜（n = 9）、肋间肌蒂（n = 9）或乳内动脉蒂移植物（n = 6）包裹。6只对照动物在无外部包裹的情况下进行支气管吻合术。所有三种类型的血管蒂移植物均证明了毛细血管从蒂长入支气管粘膜下丛的支气管血运重建;然而，乳内动脉蒂移植物提供了更一致和融合的血管长入。此外，乳内动脉组的支气管吻合横截面积明显更好（84.5 ± 0.0000）。3.3)与网膜（68.4 ±. 8.3）、海岸间肌（66.9 . ±. 10.9）或对照组（70.2 . ±. 7.6）。内乳动脉带蒂移植物和任何带蒂移植物的密集融合粘膜下血管长入的存在是最小化支气管吻合口狭窄的独立预测因素（p < 0.05）。这些数据与以前的研究结果一致，表明网膜和肋间肌蒂移植物促进早期支气管血运重建;此外，数据证明了乳内动脉蒂移植物在提供粘膜下血管长入和尽量减少吻合口狭窄方面的优越性。
Bronchial transection and devascularization is necessary in the course of sleeve resection of lung transplantation, leaving distal bronchial segments ischemic and subject to stricture or dehiscence. Thirty mongrel dogs underwent left lung autotransplantation. The bronchial anastomosis was wrapped with omentum (n = 9), intercostal muscle pedicle (n = 9), or internal mammary artery pedicle grafts (n = 6). Six control animals underwent bronchial anastomosis without an external wrap. Bronchial revascularization by capillary ingrowth from the pedicle to the bronchial submucosal plexus was demonstrated with all three types of vascular pedicle grafts; however, more consistent and confluent vascular ingrowth was provided by internal mammary artery pedicle grafts. Additionally, the bronchial anastomotic crossectional area was significantly better in the internal mammary artery group (84.5 .+-. 3.3) as compared with that of the omental (68.4 .+-. 8.3), intercoastal muscle (66.9 .+-. 10.9), or control groups (70.2 .+-. 7.6). An internal mammary artery pedicle graft and the presence of dense confluent submucosal vascular ingrowth from any pedicle graft were independently predictive (p < 0.05) of minimizing bronchial anastomotic narrowing. These data are consistent with previous findings suggesting that omental and intercostal muscle pedicle grafts promote early bronchial revascularization; moreover, the data demonstrate the superiority of an internal mammary artery pedicle graft to provide submucosal vascular ingrowth and to minimize anastomotic stenosis.