J.Jpn. Surg. Soc.. 58(4): 641-666, 1957
STUDIES ON RESECTION OF THE PERICARDIUM AND ITS PROCEDURE
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Department of Surgery, Tokyo Medical College (Director: Prof. Kingo SHINOI) Surei CHIN |
1) Resection of the pericardium following its sewing up is allowed, in safety, to the extent of one sixth of the whole.
On the contrary, all the experimental dogs whose pericardium have been sewn up to the extent of more than one-fifth (3 cm in diameter of the defected portion) died of burden of the heart on the right side.
2) On partial resection of the pericardium, it is possible to have the remaining pericardium undone if the defected portion is within 4 cm in diameter. However, a possible hazard to produce a cardiac hernia developing from the defected portion is brought about by resection of the pericardium to the extent of more than the above diameter.
There is also a possibility to cause myocardial interstitialitis even if a dog should be a long term survival.
Therefore, this procedure is not always a safety one.
3) On total resection of the pericardium, many of the experimental dogs died of rotation or axle-torsion of the heart in a postoperatively short time.
There is a possibility to produce atrophy or interstitial inflammation of the heart muscle even if a case should be a long term survival.
Accordingly, it is inadequete to resect the total pericardium without any treatment such as transplantation.
4) Tranplantation of the pericardium is the best procedure for a defected portion after resection of the pericadium.
5) A hetero or homologous pericardium preserved in alcohol are very effective as a graft for resected portion.
Pathologically, a graft is gradually replaced by granulating tissue and, then, being encapsulated with serosa in 3 months after organization achieved.
6) Clincally, our transplantation after pericardial resection in pneumonectomy for bronchogenic carcinoma, was very successful on 4 cases excluding 1 case which died of anesthesical shock in 4 hrs. after operation.
There was nothing unusual of importance noted in electrocardiogram, circulatory function and liver-function.
The present author concludes to be worth applying this procedure in clinical cases with a great expectation.
(author's abstract)
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