Villegas-Cabello O, Vázquez-Juárez J L, Gutiérrez-Pérez F M, Dávila-Córdova R F, Díaz-Montemayor C
Department of Experimental Surgery, Monterrey Medical School, Mexico.
Thorac Cardiovasc Surg. 1994 Oct;42(5):302-5. doi: 10.1055/s-2007-1016509.
The reconstruction of extensive defects of the trachea ist best accomplished by the use of the patient's own tissue. Unfortunately, this is not always feasible and several prosthetic devices for replacement of the trachea have been described. In an experimental study staged tracheal replacements were performed in five dogs using a ringed polyethylene terephthalate (PET) tubular prosthesis previously cultured in the major omentum of the subjects. A set of stainless-steel arches embodied in silicone compound was designed to prevent collapse of the prosthesis. One of the subjects died on the 10th post-operative day of an unidentified cause and the remaining four eventually developed signs of respiratory distress. The cause of the respiratory insufficiency was anastomotic stenosis in every case. Infection, erosion, collapse or displacement were not observed. The rings designed to avoid collapse of the prosthesis represent a suitable alternative for use as external reinforcement in the tracheal situation. The PET grafts implanted as tracheal prosthesis according to the guidelines of this protocol consistently developed anastomotic stenosis and failed to support a functional respiratory epithelium. A further conclusion is that the use of absorbable sutures encourages anastomotic dehiscence and thus must be avoided.
气管广泛缺损的重建最好通过使用患者自身组织来完成。不幸的是，这并非总是可行的，并且已经描述了几种用于替代气管的假体装置。在一项实验研究中，使用预先在受试者大网膜中培养的带环聚对苯二甲酸乙二酯（PET）管状假体，对五只狗进行了分期气管置换。设计了一组嵌入硅酮化合物的不锈钢弓，以防止假体塌陷。其中一只受试动物在术后第10天死于不明原因，其余四只最终出现呼吸窘迫迹象。呼吸功能不全的原因在每种情况下都是吻合口狭窄。未观察到感染、侵蚀、塌陷或移位。设计用于避免假体塌陷的环代表了一种适合用作气管外置加固的替代方法。按照本方案的指导方针植入的作为气管假体的PET移植物持续出现吻合口狭窄，并且未能支持功能性呼吸上皮。进一步的结论是，使用可吸收缝线会促使吻合口裂开，因此必须避免。
