J.Jpn. Surg. Soc.. 53(5): 344-348, 1952
Original article
THE AUTOTRANSPLANTATION OF THE THYROID AND THE PARATHYROID GLANDS WITH ANASTOMOSIS OF THEIR VESSELS
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First Department of Surgery, University of Tokyo School of Medicine (Director : Professor K. Shimizu) Hiroshi TASHIMA |
1. Too many obstructions were observed at the point of the venous anastomosis.
2. The thyroid and the internal jugular veins of the dogs are too small in caliber to get a good result in transplantation using these two veins.
The author therefore designed the following new method:
1. Transplantation of the glands together with their surrounding muscles. The detail are as follows :
a. Six weeks before the grafting, the thyroid was detached from the surrounding tissues, except the upper thyroid vessels, and inserted into the incised area of the sternomastoid muscle between the two muscular branches of the external jugular vein.
b. Three weeks after this procedure, the upper thyroid vein was double-ligated and divided so that the venous blood from the organ might not flow into the internal jugular, but into the external jugular vein.
c. At the time of grafting, the thyroid was removed together with a complete segument of the common carotid artery connected with the upper thyroid artery, a muscle-flap surrounding the gland, the two muscular branches and their related complete segment of the external jugular vein.
d. Then the free grafting was performed on the other side of the neck or at the lower inguinal region. The artery was anastomized biterminally, the vein biterminally on the neck and end-to side way at the inguinal region. The muscle-flap was sutured to the incised ends of the muscles at the new ground.
In this method, the author could find out the following three excellent points.
1. This method is able to perform on almost all dogs.
2. The external jugular vein is much larger than the internal in caliber, therefore, the venous anastomosis is much easier; therefore the results must be more accurate.
3. The venous blood from the grafts is allowed to flow into the general blood circulation not only through the new vein, but also through the muscle. (Author's abstract)
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