[Protection of the bronchial anastomosis with omental pedicle in unilateral lung transplant].
Lung transplantation has been slow to develop due mainly to the association of complications at the bronchial anastomosis secondary to the devascularization incurred during procurement. In the present study we evaluate the importance of the protection of the bronchial anastomoses with an omental pedicle. Mongrel dogs were operated upon forming four study groups: lung allotransplantation with bronchial protection (group T1, n = 9), lung allotransplantation without protection (group T2, n = 6); the two remaining groups did not receive a transplant but instead underwent surgery with extensive dissection and transection with reanastomoses of the left main bronchus with (group B1, n = 5) and without (group B2, n = 5) bronchial protection. All animals survived the surgical procedure. There were 8 complications at the bronchial anastomosis, six of which appeared in group T2 and were directly responsible for the animals death (p less than 0.05 when comparing lethal complications with group T1). Angiographic and dye perfusion studies were performed through the right gastroepiploic artery of the omentum. Bronchial neovascularization was demonstrated macroscopically as well as with light microscopy in all animals receiving protection with omentum (groups T1 and B1). We conclude that adequate bronchial protection is achieved with an omental pedicle flap brought up to the thorax during lung transplantation. It diminishes significantly the incidence of lethal complications at the bronchial anastomosis due to the revascularization that occurs through the omentum.
Santillán-Doherty
P
P
Jasso
R
R
Gaxiola
M
M
Villalba Caloca
J
J
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001980:Bronchi / Q000098:blood supply / Q000601:surgery*; D004285:Dogs; D016040:Lung Transplantation; D009852:Omentum; D011379:Prognosis; D013524:Surgical Flaps
Protección de la anastomosis bronquial con colgajo de omento en el trasplante pulmonar unilateral.