THE EFFECT OF IRRADIATION ON MICROVASCULAR ANASTOMOSIS

辐照对微血管吻合的影响

• 批准号: 07671856
• 负责人: TAHARA Shinya
• 金额: $ 1.41万
• 依托单位: KOBE UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671856/
• 关键词: MICROVASCULAR ANASTOMOSIS; VASCULAR PATECY; IRRADIATION; FREE TISSUE TRANSFER; EXPERIMENT IN RABBIT; マイクロサージャリー; 術前照射; 血栓形成

1.We had been using rats for the experimental model for microvascular anastomosis. However, rats were not suitable either for the research of long term patency or for the irradiation test. A rabbit was suitable animal for this experiment. So we confirmed weather the auricular vessels of rabbit were compatible with inguinal vessels of rat as a model of microvascular anastomosis. The inguinal artery of rat was 1.5 to 1.8 mm in diameter. We once severed this artery and reanastomosed under operation microscope and examined the patency rate 2 days later. the rate was 100% (20 vessels patent in 20 vessels anastomosed). On the other hand, the auricular central artery of rabbit was 1.0-1.5 mm in diameter. The same experiment on this vessel revealed 97.5% (39/40). The inguinal artery of rat and the auricular artery of rabbit were equally suitable for model of vascular anastomosis. The high patency rate of almost 100% was obtained in both animals, provided of which vessels were more than 1.0 mm … More in diameter.2.The clinical patency rate of the same operator was examined. The free radial forearm flap were applied for 230 clinical cases of head and neck reconstruction. The arterial pedicle of this flap was 1.5-2.0 mm in diameter. The flap failure occurred in 2 cases, and patency rate was 99.1%. The arterial pedicle of free jejunum flap was 1.0-1.5 mm in diameter. And clinical patency rate was 96.3% (79 successes in 82 grafts). Thus we considered that the auricular central artery of rabbit was suitable for the model of microvascular free tissue transfer n clinical cases.3.We made an experiment of irradiation, supposing the preoperative irradiation in head and neck surgery. Five rabbits, 10 auricle made one group. Six groups underwent irradiation of various dose. Three weeks after the irradiation of each dose 20,30,40,50 Gy, and control (0 Gy), we made microvascular anastomosis on the auricular central artery, and examined the patency rate 2 days later. The patency rates of each group were 90% in 20 Gy group, 60% in 30 Gy group, 0% in 40 Gy group, 0% in 50 Gy group and 100% in control. Over 40 Gy of preoperative irradiation remarkably imperiled the patency of anastomosed vessels. Thus we emphasise that we should take a recipient vessels in non-irradiated field, when the patient had undergone the preoperative radiation therapy more than 40 Gy in dose.4.We are now planning to examine the specimen of anastomosed vessels histologically, and to clarify the mechanism of obstruction of blood flow resulting from the preoperative irradiation. Less

1.建立了大鼠微血管吻合实验模型。然而，大鼠既不适合用于长期通畅性研究，也不适合用于辐照试验。兔子是做这个实验的合适动物。因此，本实验证实兔耳血管与大鼠腹股沟血管是否相容，可作为微血管吻合的模型。大鼠腹股沟动脉直径为1.5 ~ 1.8mm。手术显微镜下将该动脉切断，2天后复查血管通畅率。20支闭塞血管中有20支通畅，通畅率为100%。兔耳中央动脉直径1.0- 1.5mm。在该血管上进行的相同实验显示97.5%（39/40）。大鼠腹股沟动脉和家兔耳动脉同样适合于血管吻合模型。在这两只动物中获得了几乎100%的高通畅率，前提是血管大于1.0 mm ...更多信息 2.检查同一术者的临床通畅率。临床应用前臂桡侧游离皮瓣修复头颈部缺损230例。皮瓣动脉蒂直径1.5- 2.0mm。皮瓣失败2例，通畅率99.1%。游离空肠瓣动脉蒂直径1.0- 1.5mm。临床通畅率为96.3%（82例移植物中79例成功）。因此，我们认为兔耳中央动脉是一种适合于临床应用的微血管游离组织移植模型。3.进行了照射实验，假设头颈外科术前照射。家兔5只，10只耳廓为一组。6组分别接受不同剂量的照射。分别以20、30、40、50戈伊及对照组（0戈伊）照射3周后，行耳中央动脉微血管吻合术，2 d后检查通畅率。20戈伊组通畅率为90%，30戈伊组通畅率为60%，40戈伊组通畅率为0%，50戈伊组通畅率为0%，对照组通畅率为100%。术前放射剂量超过40戈伊，严重影响闭塞血管的通畅。因此，我们强调，当患者术前接受的放射治疗剂量超过40戈伊时，应在非照射野取受者血管。4.我们正计划对闭塞血管标本进行组织学检查，以阐明术前放射导致血流阻塞的机制。少