Experimental reconstruction of cervical tracheal defects with a new type of tracheal prosthesis / 中华胸心血管外科杂志

ABSTRACT

Objective: To investigate the feasibility of tracheal prosthesis made from biomaterials in the replacement of the circumferential tracheal defects. Methods: Surgical resection and replacement of the cervical trachea with different prosthesis was performed in 16 mongrel dogs. Bronchoscopic, roentgenographic, macroscopic and histopathologic examinations were employed to evaluate the efficacy of the tracheal substitutes. Results: In group A (with type-I prosthesis, n=8), one dog died from prosthetic dehiscence on 96th days postimplantation, another one died from anastomotic leakage caused by severe infection in cervical incision on postoperative 45th days. The other 6 of group A had uneventful postoperative courses and did not show any respiratory symptoms. Tracheal prostheses were completely healed with the recipient's trachea and combined in its integrity. Varied degrees of epithelial lining were observed to have formed near both the anastomotic ends. In addition, many scattered and varied sizes of neo-ossification substances were found at the sites surrounding implanted prostheses. In group B ( type-II prosthesis ,n=4), dehiscence and dislocation of implanted prostheses often occurred with time after operation, which inevitably resulted in severe and fatal postoperative complications .In group C (type-III prosthesis, n=4), all 4 dogs died within 28 days after operation. The leading causes of death were mesh exposure, collapse, infection and air leakage from implanted prosthesis itself. Conclusion: Type-I tracheal prosthesis is a suitable alternative method in reconstruction of tracheal defects, which appears very promising for the clinical application, with further improvements in promoting the epitheli alization completely.