論文

査読有り 国際誌
2015年3月

A rigid and bioabsorbable material for anterior chest wall reconstruction in a canine model.

Interactive cardiovascular and thoracic surgery
  • Masatsugu Hamaji
  • ,
  • Fumitsugu Kojima
  • ,
  • Sho Koyasu
  • ,
  • Tomomi Nobashi
  • ,
  • Tatsuaki Tsuruyama
  • ,
  • Hiroshi Date
  • ,
  • Tatsuo Nakamura

20
3
開始ページ
322
終了ページ
8
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/icvts/ivu416

OBJECTIVES: The optimal material for anterior chest wall reconstruction following chest wall resection remains controversial. The aim of this experimental study was to evaluate short-term, morphological and histological outcomes of anterior chest wall reconstruction with a rigid and bioabsorbable material in a canine model. METHODS: Twenty adult beagle dogs underwent anterior chest wall resection. In the experimental group (n = 10), the anterior chest wall was reconstructed with a rigid and bioabsorbable material composed of poly-L-lactide acid matrix (60 wt%) and uncalcined and unsintered hydroxyapatite particles (40 wt%), whereas in the control group it was (n = 10) reconstructed with dual polypropylene mesh sheets. Short-term complication rates were compared with a χ(2) test. Postoperative sternal deviations were evaluated with sternal alignment angles using computed tomography and multiplanar reconstruction and were compared with Mann-Whitney U-test immediately after reconstruction, and at 1, 3, 6, 9 and 12 months postoperatively. Histological findings of the regenerated chest wall tissue were obtained after staining with haematoxylin and eosin and Elastica van Gieson (EVG) and compared at 3, 6, 9 and 12 months. RESULTS: There was not a significant difference in the short-term postoperative complication rate (P = 0.53) and the complication rate was 20% (wound infection, n = 1 and lethal mediastinitis, n = 1) in the control group and 10% (wound infection, n = 1) in the experimental group. The postoperative sternal deviation was significantly less remarkable at 1 month (123.3 ± 32.2° vs 159.4 ± 19.7°, P = 0.027), 3 months (109.8 ± 34.7° vs 150.9 ± 34.2°, P = 0.039) and 12 months (61 ± 15.6° vs 170.3 ± 6.6°, P = 0.046) in the experimental group than in the control group, whereas no significant difference was noted immediately after reconstruction (165.7 ± 6.4° vs 168.4 ± 9.1°, P = 0.50). Histological findings showed dense connective tissue in the regenerated chest wall in both groups and showed chondroblasts in the regenerated chest wall tissue at 3 and 6 months only in the experimental group. CONCLUSIONS: Our results suggest that anterior chest wall reconstruction with a rigid and bioabsorbable material is feasible and may be a valuable alternative to reconstruction with a non-rigid and non-absorbable material.

リンク情報
DOI
https://doi.org/10.1093/icvts/ivu416
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/25505306
Scopus Url
http://www.scopus.com/inward/record.url?eid=2-s2.0-84944033776&partnerID=MN8TOARS
ID情報
  • DOI : 10.1093/icvts/ivu416
  • ORCIDのPut Code : 44605875
  • PubMed ID : 25505306
  • SCOPUS ID : 84944033776

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