ABSTRACT
Objective Discuss clinical type and treatment of postoperative digestive tract fistula and associate complications of esophageal or cardiac cancer.Methods Analized clinical manifestations and treatment retrospectively of 53 cases of digestive tract fistula after operation of esophageal or cardiac cancer from January,2010 to December,2012.Results All the 10 undergoing surgery are cured by reoperation.2 died of mediastinal infection and sepsis.4 died of respiratory failier,malnutrition,left and right bronchal fistula,respectively.Conclusion There are 4 types of fistula:Ⅰ type of sepsis,Ⅱ type of respiratory failure,Ⅲ type of thoracic infection,Ⅳ type of neck inection.Reoperation within 24 hours is the key of suscessful repairment of intrathoracic anastmotic leakage.Bronchal fistula or respiratory failure caused by multiple thoracic encapsulated effusion is also the indication of surgery.Complete lung reexpansion and complete drainage is the key.Mini-invasive VATS is the method of exact drainage.
ABSTRACT
Objective:To modify the pulsatile bioreactor we constructed previously for simulating the high-flow, high-pressure hemodynamics of heart valve in vivo, and to experimentally cultivate the tissue-engineered heart valves (TEHV) in the modified bioreactor. Methods: T-PLS system (NewheartBio Co., Ltd Korea) was used to generate pulsatile flow in the modified bioreactor and we designed a new air-exchange pathway to avoid contamination. The TEHV were made by seeding human bone mesenchymal stem cells (BMSCs) on de-cellularized porcine heart valve. After cultured under static condition for 4 d, the TEHVs were moved to the modified bioreactor and exposed to low-flow (0-600 ml/min) or high-flow(0-4 800 ml/min) pulsatile hydrodynamics for 7d, then the cells on TEHVs were evaluated. Results: After modification, the flow range expanded from (0-1 200) ml/min to (0-6 000) ml/min and the pressure range expanded from (0-40) mmHg to (0-180) mmHg. In culture experiments, 26.3% of the seeded cells remained under low-flow environment and cells were completely lost under the high-flow dynamics. Conclusion: The modified bioreactor can basically simulate the dynamics of heart valve in vivo and can be used in TEHV cultivation research. However, the current TEHV can not tolerate the high-flow pulsatile hydrodynamics.