New devices of the Continuous esophageal pouch elongator for the treatment of long gap cases of congenital esophageal atresia.

连续食管储袋延长器的新装置，用于治疗先天性食管闭锁的长间隙病例。

• 批准号: 61480263
• 负责人: SAWAGUCHI Shigenori
• 金额: $ 2.69万
• 依托单位: University of Tsukuba Institute of Clinical Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1986
• 资助国家: 日本
• 起止时间: 1986 至 1987
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-61480263/
• 关键词: congenital esophageal atresia; long gap; esophageal pouch elongator; 粘弾性数学モデル; 食道盲端延長装置; long gap症例; 食道延長装置

Fundamental studies and clincial application of the continuous esophageal pouch elongator were performed under this Grant-in-Aid.In the fundamental studies, the streching test of canine esophagus revealed that the force load necessary for tearing off the esopahgeal specimen was 4-8kgf. The force load in the clinical application up to 200 gf was taken to be well within the safty range. In this streching test, the esophagus of puppy was proven to be more easily elongated than that of abult dog. According to these measurements, a fundamental mathematical model of esophageal visco-elasticity was calculated to be F(t)= F/K(1-e^<-kt/r1>) + Ft/r_2. This is an addition of elasiticity and viscocity function.A newly devised elongator worked under direct measurement and display of the loaded force and esophageal elongation. The elongator was also devised to protect the pharyngo-esopahgeal area from harm. The elongating part was consisted of bellows artificial artery which could dilate and deflate according to a given air pressure. This part was fixed to the mouth piece plate of the individually made helmet. Contraol part was regulated by a microcomputer, which worked under the input regulating data, preset interval of presssure load and alarm circuit for preventing dangerous overload in reference to mathematical model.This apparatus was successfully applied to a patient with Gross A type esophageal atresia, with apart distance of 7 vertebral bodies between the pouches, in the course of 11 months. Direct anastomosis aided by an additional procedure of Livaditis myotomy was achieved without troubles.Lower pouch elongator is under study, but it requires some more research time for completion.

本次资助项目对连续食管储袋延长器进行了基础研究和临床应用。在基础研究中，对犬食管进行拉伸试验，撕开食管标本所需的力载荷为4-8kgf。临床应用中高达 200 gf 的力负载被认为完全在安全范围内。在这项拉伸测试中，幼犬的食道被证明比成年犬的食道更容易被拉长。根据这些测量，计算出食管粘弹性的基本数学模型为 F(t)= F/K(1-e^<-kt/r1>) + Ft/r_2。这是增加了弹性和粘性函数。新设计的伸长器在直接测量和显示负载力和食管伸长的情况下工作。延长器还旨在保护咽食管区域免受伤害。延长部分由波纹管人工动脉组成，可以根据给定的气压进行扩张和收缩。该部件固定在单独制作的头盔的咬嘴板上。控制部分由微电脑调节，根据数学模型输入调节数据，预设压力负荷间隔和报警电路，防止危险的过载。该装置成功应用于一例囊袋间距离为7个椎体的Gross A型食管闭锁患者，历时11个月。借助 Livaditis 肌切开术的额外手术顺利实现了直接吻合。下袋延长器正在研究中，但需要更多的研究时间才能完成。

项目成果

Haruo OHKAWA and Shigenori SAWAGUCHI: "Present status of neonatal surgical treatment." Obstetrical and Gynecological Therapy.56. 15-20 (1988)

Haruo OHKAWA 和 Shigenori SAWAGUCHI：“新生儿手术治疗的现状。”

大川治夫: 手術. 42. (1988)

大川春夫：手术42。（1988）

Haruo OHKAWA et al.: "Operative device for congenital lower esophageal stenosis, associated with esophageal atresia of Gross C type." Operation. 42. (1988)

Haruo OHKAWA 等人：“用于先天性下食管狭窄的手术装置，与 Gross C 型食管闭锁相关。”

大川治夫: 産婦人科治療. 56. 15-20 (1988)

大川春夫：妇产科治疗。 56. 15-20 (1988)

Haruo OHKAWA et al: "Research on the continuous esophageal pouch elongator. I. Fundamental studies and new devices of air pressure elongator." J. Jpn. Soc. Pediatr. Surg.22. 656-664 (1986)

Haruo OHKAWA 等：“连续食管储袋延长器的研究。I.气压延长器的基础研究和新装置”。