Omentopexy for tracheal autografts.

An effective method of vascularization is required in tracheal transplantation, as tracheal vessels are too find to be anastomosed easily. A series of experiments, including postmortem injection study, were conducted to assess the usefulness of omentopexy for tracheal autografts in 17 dogs. In group I (n = 4) a six-ring tracheal autograft was implanted in the greater omentum for 28 days. The structural integrity of all the autografts was maintained. In group II (n = 3) a six-ring cervical trachea was excised and reimplanted as an autograft without omental wrapping. All three autografts dissolved or transformed. No neovascularity from the recipient trachea or surrounding tissue was seen in the autografts by postoperative day 11. In group III (n = 10) omentopexy was added to the same experiment as group II. All the autografts were nourished adequately by the omental circulation as demonstrated by injection study, and remained viable early after transplantation. We conclude that the omentopexy is an effective method to facilitate neovascularization in tracheal autografts.