Kawahara Insu, Ono Shigeru, Maeda Kosaku
Division of Pediatric Surgery, Department of Surgery, Jichi Medical University School of Medicine, Tochigi, Japan.
Division of Pediatric Surgery, Department of Surgery, Jichi Medical University School of Medicine, Tochigi, Japan.
J Pediatr Surg. 2016 Dec;51(12):1967-1971. doi: 10.1016/j.jpedsurg.2016.09.020. Epub 2016 Sep 15.
Congenital tracheal stenosis (CTS) is a rare condition and difficult to treat. Slide tracheoplasty has unsatisfactory outcomes for severe neonatal symptomatic CTS. This study evaluated the use of biodegradable polydioxanone stents (BD stent) in a rabbit model of CTS.
Tracheal stenosis was induced in female Japanese white rabbits, 9-10weeks old, by direct scraping of the tracheal mucosa with a nylon brush following transverse incision of the trachea (control group, n=4). Seven days later, we incised the trachea again and inserted a BD stent (15×5mm) into the trachea (stent group, n=4). Arterial blood gas analysis was performed twice weekly for 1month after the procedure.
In the control group, respiratory acidosis arising from ventilatory failure was observed on postoperative days 7-10. Rabbits were sacrificed at 11.5days after scraping. Severe tracheal stenosis resulting from inflammatory granulation was detected in the scraped region in all rabbits. In the stent group, arterial blood gas analysis was normal at 28days after stent insertion. The BD stent maintained patency of the tracheal lumen and prolonged survival for 1month.
The use of BD stent represents a promising new treatment method for tracheal stenosis.
先天性气管狭窄（CTS）是一种罕见且难以治疗的疾病。对于严重的新生儿有症状的CTS，滑动气管成形术的效果并不理想。本研究评估了可生物降解的聚二氧六环酮支架（BD支架）在CTS兔模型中的应用。
对9至10周龄的雌性日本白兔，在气管横切后用尼龙刷直接刮擦气管黏膜诱导气管狭窄（对照组，n = 4）。7天后，再次切开气管并将BD支架（15×5mm）插入气管（支架组，n = 4）。术后1个月每周进行两次动脉血气分析。
对照组在术后第7至10天观察到因通气衰竭引起的呼吸性酸中毒。刮擦后11.5天处死兔子。所有兔子刮擦区域均检测到因炎性肉芽形成导致的严重气管狭窄。在支架组中，支架置入后28天动脉血气分析正常。BD支架维持了气管腔的通畅并延长存活时间达1个月。
BD支架的应用代表了一种有前景的气管狭窄新治疗方法。
