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Experimental tracheal reconstruction with a rotated right stem bronchus.
1Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan. h2osada@marianna-u.ac.jp
The Annals of Thoracic Surgery
|January 13, 2001
Summary
A novel surgical technique using a rotated right stem bronchus successfully reconstructed long tracheal defects in dogs. The reanastomosed right apical lobe remained expanded, though ciliary transport was lost in the inverted segment.
Area of Science:
- Thoracic surgery
- Surgical innovation
- Tracheal reconstruction
Background:
- End-to-end anastomosis is insufficient for extensive tracheal defects.
- A safer, more effective method is needed for tracheal reconstruction.
Purpose of the Study:
- To evaluate a new surgical technique for reconstructing long tracheal defects.
- To assess the viability and function of reanastomosed lung tissue.
Main Methods:
- A modified right stem bronchus was rotated into the mediastinum in nine mongrel dogs.
- A 10-cartilage-ring tracheal defect was created and repaired.
- The right apical lobe was reanastomosed end-to-side to the modified bronchus.
- Ciliary transport was assessed postoperatively.
Main Results:
- Eight of nine dogs tolerated the procedure well.
- The reanastomosed right apical lobe remained well-expanded for over a year.
- The inverted bronchial segment demonstrated no cranial ciliary transport.
Conclusions:
- Rotated right stem bronchus with reanastomosed right apical lobe is a viable method for reconstructing large tracheal defects (>10 rings).
- This technique allows for successful reconstruction but results in loss of ciliary function in the inverted segment.