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2005, Number 2

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Vet Mex 2005; 36 (2)

Macroscopic, microscopic and morphometric changes of thoracic tracheal divided graft after autotransplantation and omentopexy in dogs

Olmos-Zúñiga R, Ávila-Chávez A, Jasso-Victoria R, Sotres-Vega A, Gaxiola-Gaxiola M, Gutiérrez-Marcos LM, Soda-Merhy A, Santillán-Doherty P

Language: English/Spanish
References: 64
Page: 189-204
PDF size: 602.76 Kb.


ABSTRACT

We evaluated scarring, revascularization, macroscopic, microscopic and morphometric changes of a thoracic tracheal graft after autotransplantation using the divided tracheal graft technique and omentopexy. Twelve dogs were operated and divided in 2 groups: Group I (n = 6) autotransplantation of thoracic trachea with the divided tracheal graft technique without omentopexy. Group II (n = 6): autotransplantation of thoracic trachea with omentopexy. The animals were evaluated clinical and radiologically every day during the first week and every 2 days during the next 3 weeks. Tracheal anastomosis was evaluated by tracheoscopy immediately after surgery and once a week until the end of the study. In group II, we performed angiographic studies and ink was injected in order to asses revascularization of the tracheal anastomosis. Finally all the animals were euthanaized; and macroscopic, microscopic and morphometric evaluations were done on the tracheal grafts. All the animals survived the surgical procedure. All the animals in group II and three in group I completed the study time, with good postoperative conditions clinical and radiological. Tracheoscopy and macroscopic studies showed good tracheal graft healing and revascularization in these nine dogs. In animals from group II the angiography and ink injection showed tracheal revascularization, histologically we found inflammation and healing tissue, some of them showed neoformation vessels. Group I animals: The three survivor dogs showed inflammation and fibrosis in the cartilage and epithelium and scarcy neoformation vessels. Three dogs in group I (they do not survived the length of the study) we found dehiscence, necrosis and fistulae in the medial portion of the autotransplanted graft, as well as heavy inflammation. The morphometric studies showed a thicker anastomosis in group I animals (ANOVA P ‹ 0.05). We conclude that tracheal autotransplantation with omentopexy favors viability, revascularization and good healing of the autotransplanted graft.


REFERENCES

  1. Netter FH. Colección Ciba de ilustraciones sobre anatomía y embriología, fisiología, anatomía patológica, síntomas clínicos y tratamiento de enfermedades. Sistema Respiratorio. Barcelona España: Salvat Editores, S.A. 1984.

  2. Kunachak S, Kulapaditharom B, Vajaradul V, Rochanawutanon M. Cryopreserved, irradiated tracheal homograft transplantation for laryngotracheal reconstruction in human beings. Otolaryngol Head Neck Surg 2000; 122: 911-916.

  3. Tojo T, Niwaya K, Sawabata N, Nezu K, Kawachi K, Kitamura S. Tracheal allogenic immunoresponse is reduced by cryopreservation canine experiment. Transplant Proc 1996; 28: 1814-1815.

  4. Torres T, Santillán P, Salazar M, Villalba J, Olmos R, Lezama M, et al. Resección y doble anastomosis traqueal (estudio experimental). Rev Inst Nac Enf Resp. 1991; 4: 9-14.

  5. Shaari CM, Farber D, Brandwein, Gannon P, Urken MI. Characterizing the antigenic profile of the human trachea: implications for tracheal transplantation. Head Neck 1998; 20: 522-527.

  6. Yokomise H, Inui K, Wada H, Ueda M, Hitomi S. Tracheal transplantation in dogs for future clinical application. Transp Proc 1996; 28: 1763-1764.

  7. Torres T, Santillán P, Gaxiola M, Jasso R, Olmos R, Villalba J, et al. Criopreservación de Tráquea. Estudio Experimental. Neumología y cirugía de tórax. 1991; 1: 8-14.

  8. Davies OG, Edmiston JM, Mc Corkle HC. The repair of experimental tracheal defects with fresh and preserved homologus tracheal grafts. J Thorac Surg 1952; 23: 367-376.

  9. Salmeron J, Gannon PJ, Blackwell KE, Shaari CM, Urken ML. Tracheal transplantation: superior and inferior thyroid artery perfusion territory. Laryngos-cope 1998; 108: 849-853.

  10. Deleare P, Ziying L, Feenstra L. Tracheal autograft revascularization and transplantation. Arch Otolaryn-gol Head Neack Surg 1994; 120: 1130-1136.

  11. Rose KG, Sesterhenn K, Wustrow F. Tracheal allotransplantation in man. Lancet. 1979; 1: 433-436.

  12. Deleare P, Ziying L, Hermans R, Sciot R, Feenstra L. Experimental tracheal allograft revascularization and transplantation. J Thorac Cardiovasc Surg 1995; 110: 728-737.

  13. Park YS, Lee DY, Paik HC, Bae KM, Cho SH. The role of omentopexy in tracheal transplantation in dogs. Yonsei Med J 1996; 37: 118-124.

  14. Lenot B, Macchiarini P, Dartevelle P. Tracheal transplantation: An experimental technique with revascularisation and venous drainage. Transplant Proc 1995; 27: 1684-1685.

  15. Yokomise H, Inui K, Wada H, Ueda M, Hitomi S, Itoh H. Split transplantation of the trachea: A new operative procedure for extendeded tracheal resection. J Thorac Cardiovasc Surg 1996; 112: 314-318.

  16. Norma Oficial Mexicana NOM-062-ZOO-1999. Especificaciones técnicas para la producción, cuidado y uso de animales de laboratorio. Diario Oficial de la Federación de los Estados Unidos Mexicanos. AFIA 6 dic de 1999.

  17. Department of Health and Human Services, Public Health Service, National Institutes of 17. Health U.S.A. Guía para el cuidado y uso de los Animales de laboratorio. Edición mexicana. Academia Nacional de Medicina 2002.

  18. Academy of Surgical Research. Course of Animal Anesthesia and Models. Memories of the Course of Animal Anesthesia and Models of the 12th Annual Meeting and 1st International Conference of the Academy of Surgical Research; October 1996: Muenster, Germany. Academy of Surgical Research, 1996.

  19. American Thoracic Society. Task Group on Screening for Respiratory Disease in Occupational Settings. Surveillance for respiratory hazards in the occupational setting. Am Rev Respir Dis 1982; 126: 952-956.

  20. Cotton RT, Connor DM, Myer CM. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994; 108: 319-323.

  21. Gutiérrez LM. Transplante Heterotópico Segmentario de Tráquea en Abdomen, con y sin Inmunosupresión. Estudio Experimental en Perros (tesis de especialidad). México, D. F.: Facultad de Medicina, UNAM, 1997.

  22. Santillán-Doherty P, Jasso-Victoria R, Gaxiola M, Villaba-Caloca J. Protección de la anastomosis bronquial con colgajo de omento en el transplante pulmonar unilateral. Rev Invest Clín del Instituto Nacional de la Nutrición “Salvador Zubirán” 1989; 41: 117-122.

  23. Soda MA, Delgado A, Morales J. Manejo quirúrgico de las estenosis traqueales. Gac Med de Méx 1994; 130: 386-389.

  24. Morgan E, Lima O, Ferdman A, Luk SK, Cooper JD. Succesful revascularization of totally ischemic bronchial autografts with omental pedicle flaps in dogs. J Thorac Cardiovasc Surg 1982; 84: 204-210.

  25. Salaza JR, Pearson BW, Payne WP. Gross and microscopical blood supplie of the trachea. Ann Thorac Surg 1977; 24:100-107.

  26. Shennib H, Massard G. Airway complications in lung transplantation. Ann Thorac Surg 1994; 57:506-511.

  27. Krummel TM, Michna BA, Thomas BL, Sporn MB, Nelson JF, Salzberg AM, et al. Tranforming growth factor beta (TGF-ß) induces fibrosis in a fetal wound model. J Pediatr Surg 1988; 23: 645-652.

  28. Angell WW, Angell JD, Kosek JC. Twelve years experience with glutaraldehyde preserved porcine xenografts. J Thorac Cardiovasc Surg 1982; 87: 845-855.

  29. Peacock EE. Control of wound healing and scar formation in surgical patients. Arch Surg 1981; 116: 1325-1329.

  30. Rubin E, Farber JL. Patología Fundamentos. México, D. F:. Medica Panamericana S. A. de C.V. 1992: 37-51.

  31. Ruiz López VM. Efecto de los inmunosupresores en la cicatrización bronquial en un modelo de autotrasplante pulmonar (tesis de licenciatura). México, D. F.: Facultad de Estudios Superiores-Zaragoza, UNAM, 1996.

  32. Albes J, Klenzer T, Kotzerke J, Thiedemann K, Schafers HJ, Borts HG. Improvement of tracheal autograft revascularization by means of fibroblast growth factor. Ann Thorac Surg 1994; 57: 444-449.

  33. Netter FH. Colección Ciba de ilustraciones sobre anatomía y embriología, fisiología, anatomía patológica, síntomas clínicos y tratamiento de enfermedades. Sistema Respiratorio. Barcelona España: Salvat Editores, S.A. 1984.

  34. Kunachak S, Kulapaditharom B, Vajaradul V, Rochanawutanon M. Cryopreserved, irradiated tracheal homograft transplantation for laryngotracheal reconstruction in human beings. Otolaryngol Head Neck Surg 2000; 122: 911-916.

  35. Tojo T, Niwaya K, Sawabata N, Nezu K, Kawachi K, Kitamura S. Tracheal allogenic immunoresponse is reduced by cryopreservation canine experiment. Transplant Proc 1996; 28: 1814-1815.

  36. Torres T, Santillán P, Salazar M, Villalba J, Olmos R, Lezama M, et al. Resección y doble anastomosis traqueal (estudio experimental). Rev Inst Nac Enf Resp. 1991; 4: 9-14.

  37. Shaari CM, Farber D, Brandwein, Gannon P, Urken MI. Characterizing the antigenic profile of the human trachea: implications for tracheal transplantation. Head Neck 1998; 20: 522-527.

  38. Yokomise H, Inui K, Wada H, Ueda M, Hitomi S. Tracheal transplantation in dogs for future clinical application. Transp Proc 1996; 28: 1763-1764.

  39. Torres T, Santillán P, Gaxiola M, Jasso R, Olmos R, Villalba J, et al. Criopreservación de Tráquea. Estudio Experimental. Neumología y cirugía de tórax. 1991; 1: 8-14.

  40. Davies OG, Edmiston JM, Mc Corkle HC. The repair of experimental tracheal defects with fresh and preserved homologus tracheal grafts. J Thorac Surg 1952; 23: 367-376.

  41. Salmeron J, Gannon PJ, Blackwell KE, Shaari CM, Urken ML. Tracheal transplantation: superior and inferior thyroid artery perfusion territory. Laryngos-cope 1998; 108: 849-853.

  42. Deleare P, Ziying L, Feenstra L. Tracheal autograft revascularization and transplantation. Arch Otolaryn-gol Head Neack Surg 1994; 120: 1130-1136.

  43. Rose KG, Sesterhenn K, Wustrow F. Tracheal allotransplantation in man. Lancet. 1979; 1: 433-436.

  44. Deleare P, Ziying L, Hermans R, Sciot R, Feenstra L. Experimental tracheal allograft revascularization and transplantation. J Thorac Cardiovasc Surg 1995; 110: 728-737.

  45. Park YS, Lee DY, Paik HC, Bae KM, Cho SH. The role of omentopexy in tracheal transplantation in dogs. Yonsei Med J 1996; 37: 118-124.

  46. Lenot B, Macchiarini P, Dartevelle P. Tracheal transplantation: An experimental technique with revascularisation and venous drainage. Transplant Proc 1995; 27: 1684-1685.

  47. Yokomise H, Inui K, Wada H, Ueda M, Hitomi S, Itoh H. Split transplantation of the trachea: A new operative procedure for extendeded tracheal resection. J Thorac Cardiovasc Surg 1996; 112: 314-318.

  48. Norma Oficial Mexicana NOM-062-ZOO-1999. Especificaciones técnicas para la producción, cuidado y uso de animales de laboratorio. Diario Oficial de la Federación de los Estados Unidos Mexicanos. AFIA 6 dic de 1999.

  49. Department of Health and Human Services, Public Health Service, National Institutes of Health U.S.A. Guía para el cuidado y uso de los Animales de laboratorio. Edición mexicana. Academia Nacional de Medicina 2002.

  50. Academy of Surgical Research. Course of Animal Anesthesia and Models. Memories of the Course of Animal Anesthesia and Models of the 12th Annual Meeting and 1st International Conference of the Academy of Surgical Research; October 1996: Muenster, Germany. Academy of Surgical Research, 1996.

  51. American Thoracic Society. Task Group on Screening for Respiratory Disease in Occupational Settings. Surveillance for respiratory hazards in the occupational setting. Am Rev Respir Dis 1982; 126: 952-956.

  52. Cotton RT, Connor DM, Myer CM. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994; 108: 319-323.

  53. Gutiérrez LM. Transplante Heterotópico Segmentario de Tráquea en Abdomen, con y sin Inmunosupresión. Estudio Experimental en Perros (tesis de especialidad). México, D. F.: Facultad de Medicina, UNAM, 1997.

  54. Santillán-Doherty P, Jasso-Victoria R, Gaxiola M, Villaba-Caloca J. Protección de la anastomosis bronquial con colgajo de omento en el transplante pulmonar unilateral. Rev Invest Clín del Instituto Nacional de la Nutrición “Salvador Zubirán” 1989; 41: 117-122.

  55. Soda MA, Delgado A, Morales J. Manejo quirúrgico de las estenosis traqueales. Gac Med de Méx 1994; 130: 386-389.

  56. Morgan E, Lima O, Ferdman A, Luk SK, Cooper JD. Succesful revascularization of totally ischemic bronchial autografts with omental pedicle flapsin dogs. J Thorac Cardiovasc Surg 1982; 84: 204-210.

  57. Salaza JR, Pearson BW, Payne WP. Gross and microscopical blood supplie of the trachea. Ann Thorac Surg 1977; 24:100-107.

  58. Shennib H, Massard G. Airway complications in lung transplantation. Ann Thorac Surg 1994; 57:506-511.

  59. Krummel TM, Michna BA, Thomas BL, Sporn MB, Nelson JF, Salzberg AM, et al. Tranforming growth factor beta (TGF-ß) induces fibrosis in a fetal wound model. J Pediatr Surg 1988; 23: 645-652.

  60. Angell WW, Angell JD, Kosek JC. Twelve years experience with glutaraldehyde preserved porcine xenografts. J Thorac Cardiovasc Surg 1982; 87: 845-855.

  61. Peacock EE. Control of wound healing and scar formation in surgical patients. Arch Surg 1981; 116: 1325-1329.

  62. Rubin E, Farber JL. Patología Fundamentos. México, D.F:. Medica Panamericana S. A. de C.V. 1992: 37-51.

  63. Ruiz López VM. Efecto de los inmunosupresores en la cicatrización bronquial en un modelo de autotrasplante pulmonar (tesis de licenciatura). México, D.F.: Facultad de Estudios Superiores-Zaragoza, UNAM, 1996.

  64. Albes J, Klenzer T, Kotzerke J, Thiedemann K, Schafers HJ, Borts HG. Improvement of tracheal autograft revascularization by means of fibroblast growth factor. Ann Thorac Surg 1994; 57: 444-449.




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