Deneysel özofagus atrezisi modelinde özofagus ile trakea arası destek dokudaki farklılıklar

Amaç: Deneysel özofagus atrezisi modelinde, cerrahi tedavi sonrası özofagus fonksiyonlarında yetersizliğe neden olabilecek, özofagus ile trakea arası destek dokudaki yapısal farklılıkları ortaya koymak. Yöntem: Çalışmamızda, 18 adet Sprague-Dawley cinsi dişi sıçan ve bunlardan kontrollü olarak elde edilen 30 adet fetüs kullanıldı. Grup 1’i; annelerine gebeliklerinde hiç bir müdahale yapılmayan ve özofagus atrezisi gelişmeyen fetüsler. Grup 2’yi; annelerine hamileliklerinin 6-9. günleri arası 4 gün, intraperitoneal 2 ml serum fizyolojik verilen ve özofagus atrezisi gelişmeyen fetüsler. Grup 3’ü; annelerine hamileliklerinin 6-9. günleri arası 4 gün, intraperitoneal 2 mg/kg adriamisin verilen ve özofagus atrezisi oluşmayan fetüsler. Grup 4D’ü; annelerine hamileliklerinin 6-9. günleri arası 4 gün, intraperitoneal 2 mg/kg adriamisin verilerek ÖA’si oluşan ve distal TÖF seviyesindeki kesitlerinin değerlendirildiği fetüsler ve Grup 4P’yi; ÖA’si oluşan ve proksimal özofagus poşu seviyesindeki kesitlerinin değerlendirildiği fetüsler oluşturdu. Histopatolojik çalışma için toraksı içine alan bloklardan 5 µ kalınlığında kesitler alınıp, bağ dokusu boyalarından, Masson’s Trichorome ve Van Gieson’s ile boyandı. Trakeanın bifürkasyonu seviyesinde, özofagus ile trakeayı içine alan kesitlerde, iki yapı arasındaki alanda fibroblastlar ve kollajen lifleri sayıldı. Bulgular: Grup 4D’den alınan kesitlerdeki sayımlarla Grup 1, Grup 2, Grup 3 ve Grup 4P’den alınan kesitlerdeki sayımlar karşılaştırıldığında, Grup 4D’de fibroblast sayılarında azalma ve kollajen lif sayılarında artma saptandı. Sonuç: Trakea-özofageal fistül seviyesinde fibroblast sayılarının az, kollajen liflerinin sayıca artmış olması, embriyonel gelişim sürecinde burada bir enflamatuar olayın geliştiğini düşündürmektedir. Bu enflamatuar kollajen birikiminin doğum sonrasında da devam etmesi, özofagusun fonksiyonlarını olumsuz yönde etkileyeceği kanaatindeyiz.

The differences of connective tissue between trachea and esophagus in the experimental model of esophageal atresia

Objective: To search the differences of connective tissue between trachea and esophagus in the experimental model of esophagus atresia that makes esophageal dysfunctions after surgery. Methods: We have studied in 30 fetuses that are extracted by cesarean section from 18 pregnant Sprague-Dawley rats that are specified by vaginal plug method. The fetuses were divided into 4 groups: Group 1 control that no intervention done to their mothers during pregnancy. Group 2 sham in which only 2 ml saline was injected intraperitoneally to their mothers. Group 3 that a dose of 2 mg/kg adriamycin in 2 ml saline have injected intraperitoneally to their mothers from 6th to 9th day of pregnancy in which no esophageal atresia happened. Group 4D that 2 mg/kg adriamycin was given intraperitoneally to their mothers from 6th to 9th day of pregnancy in which esophageal atresia happened. Group 4P in which fetus had esophageal atresia and section taken only in the level of proximal esophageal atresia. All fetuses were barred in paraffin blocks for histopathologic examination and 5µ serial sections were taken from the fetal thorax. Histopathological sections were stained by Masson’s Trichorome and Van Giesons Stains. The fibroblast number and collagen fiber numbers that are between trachea and esophagus in the level of tracheal bifurcation were determined. Results: When we compared sections taken from Group 4D with Group 1, Group 2, Group 3 and Group 4P, it was found that fibroblast numbers were decreased and collagen fibers numbers were increased. Conclusion: The decrease in number of fibroblast and increase in number of collagen fibers in the level of trachea-esophageal fistula makes us to think of an inflammatory process developing during the embrional evolution, and this inflammatory collagen accumulation continues even after birth thus affect negatively the esophageal functions.

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