Evaluation of an Aortic Stent Graft for Use in Surgery on Esophageal Cancer involving the Thoracic Aorta : an experimental study

1. 目的：探讨主动脉支架植入术治疗累及胸主动脉的食管癌的可行性。方法：置入血管内支架后，在不夹持主动脉的情况下切除部分犬胸主动脉。研究一；在支架置入后立即切除长1 cm、周长1/4的主动脉全层，用腹直肌游离筋膜片覆盖。研究二；于支架置入后第3、7、14、21、28天分别切除相同大小的主动脉外膜和外半边介质。一半的狗切除的部分被自由筋膜补丁覆盖，其余的狗没有被覆盖。研究三；在支架置入后第7天切除长1cm、周长1/2的主动脉外膜及外半边中膜。在主动脉切除术后第28天和第1年分别进行组织学检查。结果：除主动脉变窄处切除1/2周长外，其余病例均可切除主动脉壁，无并发症。主动脉切除部分的愈合在有和没有筋膜覆盖之间没有差异。结论：主动脉血管内支架可以应用于累及主动脉的食管癌手术。

1. Purpose : investigate whether aortic stent grafting can be applied in treatment of an esophageal cancer involving the thoracic aorta.2. Methods : The canine thoracic aorta was partially resected without aorta clamping after emplacement of an endovascular stent graft. Study I ; The aortic whole layer of 1 cm in length and 1/4 of the circumference was resected and was covered by a free fascia patch of the abdominal rectal muscle immediately after stent graft emplacement. Study II ; The aortic adventitia and the outer half of the media of the same size was resected on day 3, 7, 14, 21, and on day 28, after the stent graft emplacement. The resected portion was covered by the free fascia patch in half dogs, and was uncovered in the others. Study III ; The aortic adventitia and the outer half of the media of 1cm in length and 1/2 of the circumference was resected and was uncovered on day 7 after stent graft emplacement. Histological examinations were performed on day 28 and at one year after aortic resection.3. Results : The aortic wall could be resected in all cases with no complication, except in resection of 1/2 the circumference where the aorta had become narrow. There was no difference in healing of the resected portion of the aorta between with and without fascia covering.4. Conclusions : An aortic endovascular stent graft could be applied in surgery for an esophageal cancer involving the aorta.