Objective To compare the biological and biomechanical characteristics of decellularized bovine jugular venous tissue-engineered valved conduit scaffolds with that of fresh bovine jugular veins. Methods Fortyeight fresh bovine jugular veins were divided into control group and experimental group with random number table method, 24 veins in each group. There were fresh bovine jugular veins in control group, decellularized bovine jugular veins in experimental group. The veins of experimental group were treated with sodium deoxyeholate plus Triton-X-100 to decellularize the cells in valves and vessel walls. The thickness, water absorption rate, water maintenance rate, destroying strength, stretch rate of valves and vessel walls in two groups were detected. Results The endothelial cell and fibroblast of valves and vessel walls in experimental group were completely decellularized, no cell fragments were retained within the matrix scaffold; collagen fiber and elastin fiber had been preserved with intact structure and wavily arrayed; deoxyribonucleic acid content of valves and vessel walls in experimental group were decreased by 97.58%, 97.25% compared with that of control group. The thickness, water absorption rate and water maintenance rate of valves and vessel walls in experimental group were lightly increased than those of control group, but there were no significant differences between them （P 〉 0. 05）. There were no significant differences in destroying strength and stretch rate of valves and vessel walls between two groups （P〉0. 05）. Conclusion Decellularized bovine jugular vein scaffold has stable biological and biomechanical characteristics and it may be ideal natural fibrous matrix for developing the tissue-engineered valved conduit by host recellularization.
ObjectiveTo summarize the prevention and treatment strategies and their effects on lymphatic leakage following transoral endoscopic thyroid cancer lateral neck lymph node dissection. MethodsA retrospective review was conducted, we collected clinical data from 47 patients with papillary thyroid carcinoma who underwent transoral endoscopic thyroidectomy and lateral neck lymph node dissection at our hospital from January 2021 to May 2023. A stepwise sequential treatment plan was adopted for patients with postoperative lymphatic leakage: low-fat, low-protein diet, continuous strong negative pressure suction, subcutaneous injection of Group A streptococcus in the surgical cavity, and ligation of the thoracic duct or lymphatic vessels through a small incision. The effectiveness of the sequential treatment plan was summarized. ResultsOut of the 47 patients, lymphatic leakage occurred in 5 cases postoperatively. Patient No.1 was cured of lymphatic leakage after sequential treatments including pectoralis major muscle flap occlusion of the jugular venous angle, low-fat, low-protein diet, continuous strong negative pressure suction postoperatively, subcutaneous injection of Group A streptococcus in the surgical field, and finally ligation of the thoracic duct or lymphatic vessels through a small incision. Patient No.20 was conservatively cured of lymphatic leakage with an initial surgical procedure involving pectoralis major muscle flap occlusion of the jugular venous angle, low-fat, low-protein diet, continuous strong negative pressure suction postoperatively, and subcutaneous injection of Group A streptococcus in the surgical field. Patient No.28 recovered after only pectoralis major muscle flap occlusion of the jugular venous angle and continuous strong negative pressure suction postoperatively. Treatment process of patient No.30 was the same as Patient No.1. Patient No.36 was treated with pectoralis major muscle flap occlusion of the jugular venous angle, low-fat, low-protein diet, and continuous strong negative pressure suction postoperatively. Through the stepwise sequential treatment measures, all 5 patients successfully recovered from lymphatic leakage; the postoperative hospital stay ranged from 3 to 17 days, with an average of 8.6 days. ConclusionsThe stepwise sequential treatment plan used in this study can effectively prevent and treat lymphatic leakage after transoral endoscopic thyroid cancer lateral neck lymph node dissection. Given the small sample size of this study, we believe it is necessary to conduct long-term studies to confirm the durability and stability of these measures.