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Khirurgii

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Year 2011 Vol. 19 No 4

GENERAL AND SPECIAL SURGERY

V.T. MALKEVICH, A.F. RYLYUK, I.A. IL'IN, A.V. PODGAYSKY

CLINICAL AND EXPERIMENTAL SUBSTANTIATION OF THE AUTOTRANSPLANT REVASCULARIZATION AT COLOESOPHAGOPLASTY

Objectives. To ground experimentally the possibility of clinical use of autotransplant from the colon as well as of its revascularization by overlaying the micro vascular anastomoses at coloesophagoplasty.
Methods. Anatomical experiment was carried out on 20 corpses of adults (14 men and 6 women) aged from 43 to 62 years (average age 52,5±1,2) with the absence of a disease of the gastrointestinal tract in the case-history. At the same time the options for the formation of colonic autotransplant from the colon were studied. As a vascular pedicle for revascularization the segments of the intersected at the base of the right colic and middle colic arteries and veins were studied.
Results. It was established that retrosternal conduction of the autotransplant to the neck as well as the resection of the cartilaginous part of the ribs at the location of autotransplant vascular pedicle contributes to the formation of free space for mobilization of the left internal thoracic vessels, and creates favorable conditions for the formation of a microvascular anastomosis.
Conclusions. The anatomical experiment was served as a prototype for the operative interventions in patients with diseases of the esophagus who needed the colon coloesophagoplasty. The proposed variant of revascularization permits to provide adequate blood supply of the oral end of autotransplant and to decrease the ischemic complications in the postoperative period.

Keywords: revascularization, autotransplant, coloesophagoplasty, internal thoracic vessels
p. 24 – 30 of the original issue
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