Morphometric parameters of ileal revascularized grafts of the cervical portion of the oesophagus in dogs.

AIMS: Gradual elaboration of the operation technique for transplantation of ileal segments in the cervical esophagus. Comparison of clinical, histomorphological and biometric characteristics of ileal segments in the case of different types of autotransplantation. MATERIAL AND METHODS: The experimental investigation on autografting segments of the ileum (both flap and tubular variants) of the cervical esophagus was carried out on 87 dogs. There were five groups of dogs and five different operating techniques were used proceeding gradually from a simple one to a more complicated one. RESULTS: The successful esophagoplasty in dogs (87) needed multi-stage modelling for the elaboration is a more efficient surgical technique. Morphological factors of the graft in the relationship with the duration of graft ischaemia and the duration of the follow-up period (1-372 days) were analysed. CONCLUSIONS: The use of ileum transplants is slightly more recommendable compared to jejunum transplants. Unfortunately even employing this method the results show moderate effect.

Venous allografts for infrainguinal vascular bypass.

Between 1978 and 1993, 107 patients received venous allografts for infrainguinal revascularization because autogenous material was unavailable. These operations comprised 7.4% of 1442 reversed vein bypass procedures performed during the same period. Alloveins were harvested during varicose vein stripping and stored up to 10 days in saline solution containing heparin and antibiotics. Veins with or without minimal degenerative changes were used and when necessary segments were sutured end-to-end to obtain a convenient length. The patients comprised 95 men and 12 women of age range 44-87 years. All operations were performed for limb salvage (rest pain and gangrene); 40 femoropopliteal and 67 femorocrural bypasses were performed; 66 were primary reconstructions and 41 secondary reconstructions. The operative mortality rate was 3.7%. Early thrombosis occurred in 18 patients (16.8%), nine of whom were successfully reoperated upon. The cumulative patency rates for all bypass operations was 82.9%, 38.7% and 21.3% at 30 days, 3 and 5 years, respectively, the limb salvage rates being 84.8%, 48.0% and 29.2%, respectively. Allografts may have a place in lower-limb bypass surgery in the absence of veins, polytetrafluoroethylene or human umbilical vein.