Tsukada Hisashi, Matsuda Shojiro, Inoue Hajime, Ikada Yoshito, Osada Hiroaki
Department of Surgery, Division of Chest Surgery, St Marianna University School of Medicine, Kawasaki, Japan.
Interact Cardiovasc Thorac Surg. 2009 Feb;8(2):225-9. doi: 10.1510/icvts.2008.186528. Epub 2008 Nov 4.
Limited information exists regarding the usefulness of bioabsorbable materials in the design of tracheal grafts. The aim of this study was to evaluate the feasibility of three bioabsorbable materials for use as artificial trachea. Three sets of grafts were prepared: Group 1 (n=6), knitted polyglactin 910 mesh; Group 2 (n=3), copolymer of L-lactide and epsilon-caprolactone sponge reinforced with polyglycoride fibers; and Group 3 (n=8), copolymer of L-lactide and epsilon-caprolactone sponge covered with knitted poly-L-lactide mesh. All grafts were internally reinforced with a titanium stent. A 10-cartilage-ring-length of canine mediastinal trachea was resected and replaced by a bioabsorbable prosthesis with the aid of an omental flap. In Groups 1 and 2, the patency rates decreased below 50% within two months after surgery. In Group 3, six of eight dogs maintained patency rates above 50% from 10 months to 2 years after surgery. Grafts prepared with a copolymer of L-lactide and epsilon-caprolactone sponge covered with knitted poly-l-lactide mesh (Group 3) can function for up to two years after surgery. These results provide evidence toward the feasibility of utilizing bioabsorbable materials as a tracheal prosthesis.
关于生物可吸收材料在气管移植物设计中的实用性,现有信息有限。本研究的目的是评估三种生物可吸收材料用作人工气管的可行性。制备了三组移植物:第1组(n = 6),针织聚乙醇酸910网;第2组(n = 3),用聚乙交酯纤维增强的L-丙交酯与ε-己内酯共聚物海绵;第3组(n = 8),覆盖针织聚-L-丙交酯网的L-丙交酯与ε-己内酯共聚物海绵。所有移植物均用钛支架进行内部增强。切除犬纵隔气管10个软骨环长度,并借助网膜瓣用生物可吸收假体进行替换。在第1组和第2组中,术后两个月内通畅率降至50%以下。在第3组中,8只犬中有6只在术后10个月至2年内保持通畅率高于50%。用覆盖针织聚-L-丙交酯网的L-丙交酯与ε-己内酯共聚物海绵制备的移植物(第3组)术后可发挥功能长达两年。这些结果为利用生物可吸收材料作为气管假体的可行性提供了证据。