Teramachi M, Nakamura T, Yamamoto Y, Kiyotani T, Takimoto Y, Shimizu Y
Department of Artificial Organs, Research Center for Biomedical Engineering, Kyoto University, Japan.
Ann Thorac Surg. 1997 Oct;64(4):965-9. doi: 10.1016/s0003-4975(97)00755-8.
Reconstruction of a long section of the trachea is clinically problematic. Tracheal reconstructions using prostheses have met with limited success due to local infection, hemorrhage, luminal stenosis and prosthesis dislocation.
We have designed a porous type of tracheal prosthesis in which the mesh is sealed with collagen sponge. We used this prosthesis (50 mm in length) to reconstruct the cervical trachea in 10 mongrel dogs and evaluated its efficacy.
One dog died due to an accident with anesthesia at 6 weeks and 1 of suffocation at 10 weeks. The other 8 dogs had an uneventful postoperative course until they were killed between 6 and 24 months after implantation. At sacrifice, all the prostheses had become completely incorporated into the host. Microscopic examination revealed advanced formation of a new epithelial lining in 1 dog at 6 months, and a confluent epithelial lining was observed in another dog at 12 months. Central stenosis was not significant in any of the animals.
This tracheal prosthesis gives good results in canine tracheal reconstruction, and appears very promising for the clinical repair of tracheal defects.
长段气管重建在临床上存在难题。使用假体进行气管重建因局部感染、出血、管腔狭窄和假体移位而成效有限。
我们设计了一种多孔型气管假体,其网孔用胶原海绵密封。我们用这种假体(长度为50毫米)对10只杂种犬的颈段气管进行重建,并评估其效果。
1只犬在6周时因麻醉意外死亡,1只在10周时窒息死亡。其他8只犬术后情况平稳,直至在植入后6至24个月之间被处死。处死时,所有假体均已完全融入宿主。显微镜检查显示,1只犬在6个月时新上皮衬里形成进展良好,另1只犬在12个月时观察到上皮衬里融合。所有动物均未出现明显的中央狭窄。
这种气管假体在犬气管重建中效果良好,在气管缺损的临床修复方面似乎很有前景。