Messineo A, Filler R M, Joseph T, Bahoric A, Smith C R
Department of Pediatrics, University of Padua, Italy.
J Pediatr Surg. 1994 May;29(5):697-700. doi: 10.1016/0022-3468(94)90744-7.
The management of congenital and acquired laryngotracheal stenosis in children often includes tracheoplasty with different materials. Autologous cartilage is the most commonly described graft for tracheal reconstruction. In 12 1-week old piglets a tracheal defect was created and repaired using cryopreserved allografts sculpted before preservation into a newly designed shape. In half the animals (group 1), a free pericardial autograft was interposed on the luminal surface of the cartilage graft. A stent was not used in any animal. The animals grew normally and were killed after 2 months. The grafted tracheas showed maintenance of their structural support, and no evidence of narrowing of the grafted area in comparison to the trachea above the graft. The lumen was lined by ciliated respiratory epithelium. There was no identifiable pericardium at the time of sacrifice and no differences between the two groups. This study shows that in neonatal pigs, cartilage allografts, sculpted before cryopreservation, are a suitable alternative to autografts to cover tracheal defects and can be used without stenting. No advantages were identified when interposing a free pericardial graft.
儿童先天性和后天性喉气管狭窄的治疗通常包括使用不同材料进行气管成形术。自体软骨是气管重建中最常被描述的移植物。在12只1周龄的仔猪中制造气管缺损，并使用在保存前雕刻成新设计形状的冷冻同种异体移植物进行修复。在一半的动物（第1组）中，将游离的心包自体移植物置于软骨移植物的管腔内表面。所有动物均未使用支架。动物正常生长，2个月后处死。移植的气管显示其结构支撑得以维持，与移植上方的气管相比，移植区域没有狭窄的迹象。管腔内衬有纤毛呼吸上皮。处死时未发现可识别的心包，两组之间也没有差异。这项研究表明，在新生猪中，冷冻保存前雕刻的软骨同种异体移植物是覆盖气管缺损的自体移植物的合适替代品，并且可以在不使用支架的情况下使用。插入游离心包移植物时未发现优势。
