Cohen R C, Filler R M, Konuma K, Bahoric A, Kent G, Smith C
J Pediatr Surg. 1985 Dec;20(6):852-8. doi: 10.1016/s0022-3468(85)80054-3.
A defect was created in the thoracic trachea in nine piglets (10 kg) by excising a segment from the entire thoracic trachea proximal to the right upper lobe bronchus (3 to 3.5 cm in length) and 30% of the circumference in width (1 to 1.5 cm). The defect was repaired with a free tibial periosteal graft (FPG) and in four piglets an omental pedicle graft (OPG) was applied to the surface of the FPG. An internal tracheal splint was inserted for 12 to 16 days to support the repair and prevent air leak. The splints were removed bronchoscopically. None of the pigs developed signs of airway obstruction at any stage following the repair. Eight were killed 3 months postoperatively when four to six times their original weight. One pig died on the 18th postoperative day of unknown cause. The tracheas were removed, x-rayed, and examined grossly and histologically. The results demonstrated normal tracheal growth with absence of either stenosis, collapse, or granulation tissue. All grafts were viable, bone formation was present, and the lumenal surfaces were lined with columnar and respiratory epithelium. The OPG did not improve vascularization of the FPG. This model suggests that tracheal stenosis in children may be surgically corrected by simply incising the stenotic segment longitudinally and enlarging the tracheal diameter by inserting a FPG into the defect.
在9只体重10千克的仔猪的胸段气管制造缺损，方法是切除右上叶支气管近端整个胸段气管的一段（长度为3至3.5厘米），宽度为周长的30%（1至1.5厘米）。缺损用游离胫骨骨膜移植片（FPG）修复，4只仔猪在FPG表面应用带蒂大网膜移植片（OPG）。插入气管内夹板12至16天以支撑修复并防止漏气。通过支气管镜取出夹板。修复后的任何阶段，没有一只猪出现气道阻塞的迹象。8只猪在术后3个月体重增至原来的4至6倍时被处死。1只猪在术后第18天不明原因死亡。取出气管，进行X光检查，并进行大体和组织学检查。结果显示气管生长正常，无狭窄、塌陷或肉芽组织。所有移植片均存活，有骨形成，管腔内表面衬有柱状和呼吸上皮。OPG并未改善FPG的血管化。该模型表明，儿童气管狭窄可通过简单地纵向切开狭窄段并将FPG插入缺损处扩大气管直径来进行手术矫正。
