W-plasty technique in tracheal reconstruction: a new technique? An experimental study

Tracheal stenosis and dehiscence of anastomosis due to excessive tension are well-known problems after long-segment tracheal resections. The aim of this study was to evaluate the efficacy of the W-plasty technique to prevent these two complications.

Animals were divided into a study and a control group. Each group consisted of 6 animals. In the control group, we performed a 5-cm tracheal segment resection, and then reconstruction was performed with an interrupted technique with 6/0 Prolene sutures. In the study group, we used the W-plasty technique with 6/0 Prolene interrupted sutures. The animals were sacrificed on the 30th day postoperatively and tracheal resection including the entire anastomosis site was performed. The traction and pullout test was applied to each specimen and all the specimens were analysed histopathologically. The intraluminal diameter and the thickness of the tracheal wall at the level of anastomoses were measured by using a micrometer. The pattern of the reaction and localization were recorded.

The traction and pullout test results were 131.6 +/- 4.3 g and 187.5 +/- 6.4 g in the control and the study group, respectively, which was a significant difference (p = 0.004). The intraluminal diameters were 3.3 +/- 1.2 mm and 4.3 +/- 0.9 mm in the control and study group, respectively (p = 0.134). In contrast to the control group, early inflammatory and late fibroblastic reactions were negative in the study group.

Considering the outcomes of this study, we think that the W-plasty technique has much more advantages than the standard techniques in terms of anastomosis durability and development of stenosis.