[Partial replacement of the trachea with jejunal autograft in the dog]

Extensive lesions of the cervical trachea can occur as a result of malformation, inflammation, tumor disease or trauma. If a short segment of the trachea is resected primary anastomosis may be possible. The problem of how to treat lesions longer than 50% of total tracheal length is still unresolved. The aim of our study was to clarify the possible use and limitations of small bowel interposition for tracheal replacement in veterinary model. We resected 6 cm of the cervical trachea of 5 adult mongrel dogs. Autolog jejunum free flap was used for replacement. The wall of the implant was supported with 5 polytetrafluoroethylene rings placed on the outer surface of the bowel perpendicular to its axis. We performed the surgery in two stages. Intraoperative tracheostomy was necessary in every case. The tracheal tube extended through the whole length of the implant. The survivals, the viability of the graft and complications were examined. The length of survival ranged between 18 h and 72 h. In one case obstruction of the tracheal tube occurred, in 3 cases the micro vessel anastomosis of the graft thrombosed, in one case both complications developed. In our experience use of the small bowel flap was complicated with fatal technical difficulties. The micro vessel anastomosis proved to be highly risky. Further investigations are needed to improve the results with this method.