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首页> 外文期刊>Surgical Endoscopy >Gastric ischemic conditioning increases neovascularization and reduces inflammation and fibrosis during gastroesophageal anastomotic healing.
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Gastric ischemic conditioning increases neovascularization and reduces inflammation and fibrosis during gastroesophageal anastomotic healing.

机译：胃缺血调节在胃食管吻合愈合过程中增加了新生血管形成并降低了炎症和纤维化。

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The incidence of anastomotic leak and stricture after esophagectomy remains high. Gastric devascularization followed by delayed esophageal resection has been proposed to minimize these complications. We investigated the effect of ischemic conditioning duration on anastomotic wound healing in an animal model of esophagogastrectomy.North American opossums were randomized to four study groups. Group A underwent immediate resection and gastroesophageal anastomosis. Groups B, C, and D were treated with delayed resection and anastomosis after a gastric ischemic conditioning period of 7, 30, and 90 days, respectively. Gastric conditioning was performed by ligating the left, right, and short gastric vessels. An intraabdominal esophagogastric resection and anastomosis was performed, followed by euthanasia 10 days later. Outcome variables included anastomotic bursting pressure, microvessel concentration, tissue inflammation, and collagen deposition.Twenty-four opossums were randomized to groups A (n = 7), B (n = 8), C (n = 5), and D (n = 4). Subclinical anastomotic leak was discovered at necropsy in 5 animals: 3 in group A, and 1 each in groups B and C (p = 0.295). The anastomotic bursting pressure did not differ significantly between groups (p = 0.545). A 7 day ischemic conditioning time did not produce increased neovascularity (p = 0.900), but animals with a 30 day conditioning time showed significantly increased microvessel counts compared to unconditioned animals (p = 0.016). The degree of inflammation at the healing anastomosis decreased significantly as the ischemic conditioning period increased (p = 0.003). Increasing delay interval was also associated with increased muscularis propria preservation (p = 0.001) and decreased collagen deposition at the healing anastomosis (p = 0.020).Animals treated with 30 days of gastric ischemic conditioning showed significantly increased neovascularity and muscularis propria preservation and decreased inflammation and collagen deposition at the healing anastomosis. These data suggest that an ischemic conditioning period longer than 7 days is required to achieve the desired effect on wound healing.
机译：食道切除术后吻合泄漏和狭窄的发生率仍然很高。已经提出了胃憩室化，然后提出了延迟食管切除，以最大限度地减少这些并发症。我们调查了缺血性调理持续时间对食管基因力切除术动物模型中吻合伤害愈合的影响。北美疗法被随机分为四个研究组。组接受的立即切除和胃食管吻合术。在7,30和90天的胃缺血性调节期后，将B，C和D延迟切除和吻合术治疗。通过连接左，右和短的胃容器进行胃部调理。进行肿瘤食管切除和吻合术，然后10天后进行安乐死。结果变量包括吻合突发压力，微血管浓度，组织炎症和胶原沉积。将44个扑张随机化为A（n = 7），B（n = 8），c（n = 5），d（n = 4）。在5只动物的尸检中发现亚临床吻合泄漏：3组中的3，并且在B和C组中，1（p = 0.295）。组之间的吻合突发压力没有显着差异（P = 0.545）。 7天缺血性调理时间没有产生增加的新生血管（p = 0.900），但与无条件的动物相比，30天调理时间的动物显着增加了微血管计数（p = 0.016）。随着缺血性调节期的增加（p = 0.003），愈合吻合术处的炎症程度显着下降（p = 0.003）。增加的延迟间隔也与增加的肌肉血栓保存（p = 0.001）相关（p = 0.001），并且在愈合吻合术（p = 0.020）下降的胶原沉积（p = 0.020）。用30天胃缺血调理治疗的animals显示出显着增加的新生血管性和肌肉血栓保护和炎症下降和胶原沉积在愈合吻合。这些数据表明，需要超过7天的缺血性调节期，以达到对伤口愈合的预期效果。

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