气管置换术:范围回顾。

IF 0.8 Q4 SURGERY
Surgery Journal Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI:10.1055/s-0044-1792126
Darin T Johnston, David B Powers, Matthew G Hartwig, Russel R Kahmke, Linda C Cendales
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引用次数: 0

摘要

目的总结历史上和目前人类长段气管置换术的患者特点和疗效。材料和方法单一审稿人使用covid - ence对摘要和全文进行筛选,进行文件管理。英文发表的研究报告包括了人类受试者进行了环周或近环周(bbb270度)的颈椎气管置换术。单纯接受一期吻合治疗的文章、撤稿文章、摘要、专家意见文章和会议报告均被排除。结果总共有32篇文章包括在审查报告156例长段气管更换包括合成n = 6/64)(活着在1 - 8年,再生医学(死在15 days-55月n = 4,没有报告n = 6),尸体的气管同种异体移植物(活着5 months-10年n = 32/38),主动脉同种异体移植物(活着在6 - 85个月n = 12/16),免费组织转移(在6 - 108个月n = 13/21),异体移植术(在6日到24日个月n = 5/8),血管复合异体移植(VCA)(存活时间为20个月n = 1/1)。结论硅胶假体和Marlex假体的远期疗效较差。尸体气管异体移植物只能替代近周的气管缺陷,因此仅限于良性气管病理。结构支持不足困扰着同种异体主动脉移植物,通常需要多次侵入性手术和维持腔内支架。除了尸体气管异体移植和VCA外,所有的气管置换方法都存在粘膜纤毛清除不足的问题,这可能导致致命的粘膜堵塞和慢性肺部感染。VCA和同种异体移植需要长期免疫调节治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tracheal Replacement: A Scoping Review.

Objective  To summarize patient characteristics and outcomes for the historical and current methods of long-segment tracheal replacement in humans. Materials and Methods  A single reviewer screened the abstracts and full texts using Covidence for file management. Studies published in English that reported human subjects with circumferential or near-circumferential (>270 degrees) cervical tracheal replacements were included. Articles with subjects treated with primary anastomosis alone, retracted articles, abstracts, expert opinion articles, and conference presentations were excluded. Results  A total of 32 articles were included in the review reporting 156 cases of long-segment tracheal replacement including synthetic (alive at 1-8 years n  = 6/64), regenerative medicine (dead at 15 days-55 months n  = 4, not reported n  = 6), cadaveric tracheal allograft (alive at 5 months-10 years n  = 32/38), aortic allograft (alive at 6-85 months n  = 12/16), free tissue transfer (alive at 6-108 months n  = 13/21), allotransplantation (alive at 6-24 months n  = 5/8), and vascular composite allograft (VCA) (alive at 20 months n  = 1/1). Conclusion  Silicone and Marlex prostheses have poor long-term outcomes. The cadaveric tracheal allograft can only replace near-circumferential tracheal defects and is therefore limited to benign tracheal pathology. Inadequate structural support plagues the aortic allograft and often requires numerous invasive procedures and maintenance of an intraluminal stent. A lack of mucociliary clearance exists in all methods of tracheal replacement except cadaveric tracheal allograft and VCA and can cause fatal mucous plugging and chronic pulmonary infections. VCA and allotransplantation require long-term immunomodulation therapy.

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来源期刊
Surgery Journal
Surgery Journal SURGERY-
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审稿时长
12 weeks
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