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Optimal dose of basic fibroblast growth factor for long-segment orthotopic tracheal autografts  Ryoichi Nakanishi, MD, Nobuyuki Nagaya, MD, Takashi Yoshimatsu,

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Presentation on theme: "Optimal dose of basic fibroblast growth factor for long-segment orthotopic tracheal autografts  Ryoichi Nakanishi, MD, Nobuyuki Nagaya, MD, Takashi Yoshimatsu,"— Presentation transcript:

1 Optimal dose of basic fibroblast growth factor for long-segment orthotopic tracheal autografts 
Ryoichi Nakanishi, MD, Nobuyuki Nagaya, MD, Takashi Yoshimatsu, MD, Takeshi Hanagiri, MD, Kosei Yasumoto, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 113, Issue 1, Pages (January 1997) DOI: /S (97) Copyright © 1997 Mosby, Inc. Terms and Conditions

2 Fig. 1 Bronchoscopic findings in canine tracheal autograft on postoperative day 370 in group IV (dog No. 14). A, Anastomotic site at oral end; B, midportion of graft; C, anastomotic site at caudal end. Graft was covered with glossy mucosa and showed good patency. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

3 Fig. 1 Bronchoscopic findings in canine tracheal autograft on postoperative day 370 in group IV (dog No. 14). A, Anastomotic site at oral end; B, midportion of graft; C, anastomotic site at caudal end. Graft was covered with glossy mucosa and showed good patency. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

4 Fig. 1 Bronchoscopic findings in canine tracheal autograft on postoperative day 370 in group IV (dog No. 14). A, Anastomotic site at oral end; B, midportion of graft; C, anastomotic site at caudal end. Graft was covered with glossy mucosa and showed good patency. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

5 Fig. 2 Cumulative percent survival. Survival in group IV differed significantly from survival in other groups (group IV versus groups I and II, p = ; group IV versus groups III, V, and VI, p = ). Survival in groups III, V, and VI differed significantly from survival in groups I and II (p = ). Mean survival time of each group was as follows: groups I and II, 9 days; groups III, V, and VI, 33 days. Mean survival time for group IV was not measured because animals were killed. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

6 Fig. 3 Canine tracheal autograft on postoperative day 12 in group I (dog No. 3). A, Gross findings; B, histologic findings (hematoxylin-eosin stain; original magnification ×12.5). Autograft is necrotic and cartilage is disintegrated or dissolved. Epithelial regeneration is not seen. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

7 Fig. 3 Canine tracheal autograft on postoperative day 12 in group I (dog No. 3). A, Gross findings; B, histologic findings (hematoxylin-eosin stain; original magnification ×12.5). Autograft is necrotic and cartilage is disintegrated or dissolved. Epithelial regeneration is not seen. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

8 Fig. 4 Canine tracheal autograft on postoperative day 393 in group IV (dog No. 14). A, Gross findings; B, histologic findings (hematoxylin and eosin stain; original magnification ×12.5); C, epithelial morphology (original magnification ×100). Tracheal continuity is restored by autograft. Many vessels and proliferation of submucosal connective tissue and cartilage are seen, but narrowing of graft is not seen. Epithelium is almost completely restored (89.1%) and is composed of nearly normal mucociliary epithelium (epithelial regeneration score = 2.24). The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

9 Fig. 4 Canine tracheal autograft on postoperative day 393 in group IV (dog No. 14). A, Gross findings; B, histologic findings (hematoxylin and eosin stain; original magnification ×12.5); C, epithelial morphology (original magnification ×100). Tracheal continuity is restored by autograft. Many vessels and proliferation of submucosal connective tissue and cartilage are seen, but narrowing of graft is not seen. Epithelium is almost completely restored (89.1%) and is composed of nearly normal mucociliary epithelium (epithelial regeneration score = 2.24). The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

10 Fig. 4 Canine tracheal autograft on postoperative day 393 in group IV (dog No. 14). A, Gross findings; B, histologic findings (hematoxylin and eosin stain; original magnification ×12.5); C, epithelial morphology (original magnification ×100). Tracheal continuity is restored by autograft. Many vessels and proliferation of submucosal connective tissue and cartilage are seen, but narrowing of graft is not seen. Epithelium is almost completely restored (89.1%) and is composed of nearly normal mucociliary epithelium (epithelial regeneration score = 2.24). The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

11 Fig. 5 Average graft patency. Data are presented as mean plus or minus standard error. *, **, p < 0.05 versus group I at that time; #, ##, p < 0.05 versus group II at that point (graft patency 7 days after transplantation: groups I versus IV, p = ; I versus VI, p = ; II versus IV, p = ; II versus VI, p = , and graft patency at observed end-point: groups I versus IV, p = ; I versus VI, p = ; II versus IV, p = ). Autografts in group IV showed good patency throughout entire postoperative course and were significantly superior to those in groups I and II, which did not receive bFGF. FG, Fibrin glue; rGEA, wrapping of omental flap fed by right gastroepiploic artery; rGEA + SA, omental wrapping fed by blood supplies from both right gastroepiploic and splenic arteries. Open bars represent graft patency 7 days after transplantation; solid bars represent patency at observed end-point. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

12 Fig. 6 Number of blood vessels in tracheal grafts. Data are presented as mean plus or minus standard error. *, p < 0.05 versus group I; #, p < 0.05 versus group II (groups I versus IV, p = ; I versus V, p = ; I versus VI, p = ; II versus IV, p = ; II versus V, p = ; II versus VI, p = ). Autografts in group IV showed highest number of vessels and were significantly superior to those in all groups except for group VI. Vessel numbers of groups V and VI differed significantly from those of other three groups, except for group IV, but did not differ significantly from each other. FG, Fibrin glue; rGEA, wrapping of omental flap fed by right gastroepiploic artery; rGEA + SA, omental wrapping fed by blood supplies from both right gastroepiploic and splenic arteries. The Journal of Thoracic and Cardiovascular Surgery  , 26-36DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

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