|Budget Amount *help
¥1,900,000 (Direct Cost : ¥1,900,000)
Fiscal Year 1999 : ¥700,000 (Direct Cost : ¥700,000)
Fiscal Year 1998 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1997 : ¥700,000 (Direct Cost : ¥700,000)
Recently, preoperative radiotherapy has been performed for advanced non-small cell lung cancer. On the other hand, sleeve lobectomy has been increased to keep the lung function for operation. The effect of preoperative irradiation on healing of bronchial anastomosis has not been published. In 1997 and 1998, we studied the effects of preoperative irradiation on healing of bronchial anastomosis in the rat. Animals were irradiated for mediastinal region, a single dose of 10, 20, 30 and 40Gy. On the third, seventh 14th or 28th days after irradiation, animals were performed left bronchoplastic surgery of left main bronchus under general anesthesia. On the third or seventh postoperative day, animals were sacrificed and measured bursting pressure and hydroxyproline content. Histological analysis were performed with Hematoxylin-Eosin stain of the bronchial anastomoses. In 1999, we studied the effect of preoperative chemoradiotherapy. A single dose of 20Gy irradiation plus CAV or PVP were selected.
In the preoperative irradiation study, bursting pressure measurement showed preoperative 10Gy and 20Gy groups were significantly higher than 30Gy and 40Gy groups. Hydroxyproline content of the anastomoses were not significant difference between the groups. Histologically, extracellular matrix of anastomoses in 30Gy and 40Gy groups was lower than control, 10 and 20Gy groups. Our results suggest that the safe preoperative interval after irradiation were within 14 days. The wound healing of preoperative chemoradiotherapy group were impaired more significantly than that of control group and preoperative chemotherapy group.
Preoperative 10Gy and 20Gy irradiation did not impair the wound healing, but in 30Gy and 40Gy groups, the wound healing was impaired significantly on 7th postoperative day. These data indicate that the effect of preoperative radiotherapy was more affected on the impairment of wound healing than preoperative chemotherapy.