저온열처리한 개의 대퇴 혈관의 변화에 대한 실험적 연구

An Experimental Study on the Changes in the Pasteurized Femoral Vessels of the Dogs

The pasteurization of bone tumor shows necrosis of tumor tissue and it is used widely as one of the options of limb salvage operation. However malignant tumors of the extremities commonly involve major neurovascular structures and pasteurization of this structure will make limb salvage operation much easier and safer than autogenous vein graft or artificial vessel graft. So the purpose of this study is to evaluate that the pasteurization can be applied in the limb salvage surgery of malignant tumor involving major vessels by means of studying the patency of pasteurized femoral vessels of the dogs. The right femoral arteries of 5 to 7 mm in diameters and veins of 7 to 10 mm in diameters of five dogs were pasteurized with sterile $60^{\circ}C$ saline for 30 minutes. Contralateral femoral vessels were evaluated for the control study. After one month, the changes in the pasteurized femoral vessels were evaluated by physical examinations, femoral angiography, gross findings, and pathologic findings on the each side. One month after pasteurization, the pulse of the femoral and popliteal arteries was palpated with normal tone on the each side of the all five experimental animals, and there was no gross swelling or necrotic changes in the legs. Femoral angiography showed a good patency of femoral and popliteal arteries. On the gross examinations at time of sampling of the specimen for the pathologic examinations, there was a good patency of femoral artery and vein, and mild fibrous adhesion was noted around the pasteurized femoral vessels. On the pathologic examinations, the more fibrotic adhesion and neocapillarization were noted in the outer layer of adventitia of the pasteurized femoral arteries and veins than the control sides. The vascular lumina were also patent in all cases. With these results, we suggest that the malignant tumor of the extremity involving major vessels is possibly treated by the limb salvage operation using the pasteurization of the involved vessels.