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Effect of three interventional bronchoscopic methods on tracheal stenosis and the formation of granulation tissues in dogs

ZHANG Jie WANG Ting WANG Juan PEI Ying-hua XU Min WANG Yu-ling ZHANG Xia WANG Chen

中华医学杂志(英文版)2010,Vol.123Issue(5):621-627,7.
中华医学杂志(英文版)2010,Vol.123Issue(5):621-627,7.DOI:10.3760/cma.j.issn.0366-6999.2010.05.021

Effect of three interventional bronchoscopic methods on tracheal stenosis and the formation of granulation tissues in dogs

Effect of three interventional bronchoscopic methods on tracheal stenosis and the formation of granulation tissues in dogs

ZHANG Jie 1WANG Ting 2WANG Juan 2PEI Ying-hua 2XU Min 2WANG Yu-ling 2ZHANG Xia 2WANG Chen1

作者信息

  • 1. Department of Pulmonary and Critical Care Medicine,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China
  • 2. Department of Pulmonary Medicine,Beijing Tian Tan Hospital,Capital Medical University,Beijing 100050,China
  • 折叠

摘要

Abstract

Background Therapeutic approaches for tracheal stenosis caused by the formation of exuberant granulation tissues usually include electrocautery, mechanical dilation, laser therapy, argon plasma coagulation (APC), cryotherapy and stent placement. However, restenosis after stent insertion remains a significant limitation. We examined the efficacy of three different approaches, including induction of mechanical lesions, APC performed with different powers or durations and cryotherapy, to identify the method that limited the formation of granulation tissue. Methods Twelve specially bred research mongrel dogs were divided into three groups. In group 1 (four dogs) mild (procedure 1; two dogs) or moderate (procedure 2; two dogs) damage was induced mechanically. Group 2 (six dogs) received APC at different powers or durations (procedure 3:30 W, 1 amis; procedure 4:30 W, 2 cm/s; procedure 5:25 W, 3 cm/s). Group 3 (two dogs) received cryotherapy (procedure 6: two freeze-thaw cycles of 30 seconds). Uncovered self-expandable metallic stents were inserted in all dogs to maintain a continuous stimulus to the trachea mucosa. Dogs were monitored for 4 weeks and the relationship between granulation tissue proliferation and method used was analyzed. Results In group 1, granulation tissue growth increased with more severe mechanical damage. The growth of granulation tissue in group 2 was more pronounced than in group 1, and both dogs in procedure 3 died because of severe stenosis. In this group, the formation of granulation tissue decreased with decreasing power and duration. In group 3, no obvious granulation tissue was found at week 4. Conclusions Lesions and stimuli from a foreign body (the stent) are two important factors that lead to overgrowth of granulation tissue. Thermal lesions, such as APC, seem to induce greater granulation tissue growth and cartilage damage compared with mechanical and cryotherapy lesions. Cryotherapy in combination with mechanical dilation may be a safe and effective treatment method for managing tracheal stenosis caused by the formation of granulation tissue.

关键词

interventional bwnchoscopy/tracheal stenosis/granulation tissue

Key words

interventional bwnchoscopy/tracheal stenosis/granulation tissue

引用本文复制引用

ZHANG Jie,WANG Ting,WANG Juan,PEI Ying-hua,XU Min,WANG Yu-ling,ZHANG Xia,WANG Chen..Effect of three interventional bronchoscopic methods on tracheal stenosis and the formation of granulation tissues in dogs [J].中华医学杂志(英文版),2010,123(5):621-627,7.

基金项目

This study was supported by a grant from the Science and Technology Project of Beijing Commission of Education (No. KM200810025005) (No. KM200810025005)

中华医学杂志(英文版)

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0366-6999

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