Issn Print: 1058-2916

Publication Date: 2000/03/01


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STUDY ON REPLACEMENT OF TRACHEAL DEFECT WITH AUTOGENOUS MUCOSA-LINED TRACHEAL PROSTHESIS MADE FROM POLYPROPHYLENE MESH

S. W. Suh; J. G. Kim; C. W. Beak; H. J. Kim

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Excerpt

Objects: Reliable prosthetic or tissue graft of trachea has not been developed yet for reconstruction of large, circumferential tracheal defect. Major limitation was anastomotic dehiscence and stenosis, which was attributed to the poor epithelinization and vascularization of the prosthetic graft. We developed the new tracheal prosthesis which has well-vasculized and viable mucosa. Method: The prosthesis consists of Prolene mesh reinforced with polypropylene rings, and coated with gelatin. And we lined the luminal surface of the prosthesis with transplanted autogenous oral mucosa and wrapped the prosthesis with greater omentum. Neovascularization and maintenance of viability of the transplanted mucosa was assessed by angiographic and histological analysis in 5 adult mongrel dogs. Then, complete surgical resection and replacement of a segment (4 cm in length, seven to eight tracheal rings) of the thoracic trachea was performed in 12 adult mongrel dogs.
Result: The transplanted mucosa was well-vasculized and maintained its normal histology in pre-replacement analysis. The dogs with tracheal replacement gained their full activity and did not show any respiratory problems until sacrifice at 2, 4 and 6 months. The prostheses were completely incorporated by the host trachea prosthesis in all dogs and confluent epithelization was confirmed histologically from the upper to the lower anastomotic site of the prosthesis.
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