食道癌大動脈浸潤における大動脈血管内ステントの応用に関する研究

主动脉血管内支架在食管癌主动脉侵犯中的应用研究

• 批准号: 12770712
• 负责人: 笹原 弘子
• 金额: $ 1.34万
• 依托单位: Kurume University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12770712/
• 关键词: 大動脈内ステントグラフト; 大動脈部分切除; 大動脈食道瘻; 大動脈浸潤食道癌; 大動脈血管ステント; 食道癌

径0.35mmのステンレスワイヤーを用いZ-ステントを作成,その周囲に有孔度150cc直径12mmと14mmのウーブングラフト人工血管を6-0ナイロンで縫合固定し長径5cmのステントグラフトを作成した.体重約15〜27Kgの雑種成犬を用い,全身麻酔下に腹部大動脈より16Frシースを使用して胸部下行大動脈にステントグラフトを内挿留置した.実験(1)ステントグラフト留置3日,1,2,3,4週後に開胸を行い,それぞれ留置部大動脈壁を長径1cm,1/4周,中膜まで切除し切除部大動脈壁を腹直筋筋膜で被覆する群と被覆しない群を作成した.4週後,6ヵ月,1年後に動脈造影と開胸下エコーを行った.切除1年後に犠死させ胸部下行大動脈を摘出し組織学的検索を行った.実験(2)ステントグラフト留置1週後に開胸を行い,留置部大動脈壁を長径1cm,1/2周,中膜まで切除した.切除部の被覆はせず,4週後,6ヵ月,1年後に動脈造影と開胸下エコーを行い,切除1年後に犠死させ,組織学的検索を行った.実験(3)ステントグラフト留置直後に大動脈壁を長径1cm,1/4周,全層切除し腹直筋筋膜にて切除部を被覆した.4週後,6ヵ月,1年後に動脈造影と開胸下エコーを行い,切除1年後に犠死させ組織学的検索を行った.【結果】(1)大動脈壁部分切除は容易に施行でき,大動脈壁切除面からの出血は認めなかった.切除に伴うステントグラフトの損傷やmigrationは認めなかった.部分切除後に出血,migration等の合併症はみられなかった.組織学的には2群間に治癒の差異は認めなかった.(2)1/2周切除は容易に行えたが,経過観察6ヶ月からグラフト留置大動脈の中枢側の拡張が認められた.(3)ステント留置直後であっても切除は可能であった.動脈血流はグラフトによって遮断されていた.経過観察期間に合併症はみられなかった.

Diameter 0.35mm diameter 12mm diameter 14mm diameter diameter 150cc diameter diameter 12mm diameter 14mm diameter 15 mm diameter 16 mm diameter 15 mm diameter 15 mm diameter 16 mm diameter 15 mm 15 mm diameter 15 mm 15 mm 15 mm Adult dogs weighing about 15 to 27Kg were used in general anesthesia, and the abdominal arteries were used in 16Fr groups, and the thoracic arteries were used in 16Fr groups. After 3 days, 1, 2, 3 and 4 weeks, the chest was opened, and the length of the arterial wall of the left part was 1 cm. After 1/4 weeks, the tunica media was removed, and the abdominal straight tendon fascia was covered. After 4 weeks, 6 months and 1 year, the arteriography was performed. One year after the resection, the descending thoracic arteries were extracted and histologically examined. (2) After 1 week of indwelling, the chest was opened and the arterial wall of the indwelling part was 1 cm in length and 1/2 weeks in diameter. The middle membrane was removed. The covering of the excised part was performed 4 weeks later, 6 months later, 1 year later, angiography and thoracotomy were performed, 1 year later, histological examination was performed. 3) After the artery wall was left straight, the diameter of the artery wall was 1 cm,1/4 weeks, the whole layer was excised, and the excised part of the abdominal straight fascia was covered. 4 weeks later, 6 months later, 1 year later, the arteriography was performed under the chest, and 1 year later, the histological examination was performed. Results: (1) Partial aortic wall resection was easy to perform, but the aortic wall resection surface was bleeding. Removal of damage and migration. Complications of partial resection include bleeding,migration, etc. Histological differences between the two groups are recognized. (2)1/2 weeks of resection is easy to move, and the observation is 6 months. (3)After a while, he was able to cut off his hair. Arterial blood flow is blocked. During the observation period, complications occurred.

项目成果

笹原弘子: "大動脈浸潤を疑った食道癌の出血予防に大動脈血管ステントグラフト内挿術を施行した一例"手術. 第55巻 第13号. 2105-2109 (2001)

Hiroko Sasahara：“主动脉血管支架植入术预防疑似主动脉侵犯的食管癌出血的病例”，《外科》，第 55 卷，第 13 期。2105-2109 (2001)。