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Experimental tracheal replacement using the esophagus and an expandable metallic stent
1Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Surgery Today
|January 1, 1995
Summary
Autologous esophageal segments supported by expandable metallic stents (EMS) showed potential as tracheal substitutes in dogs. While not clinically feasible, this research suggests alternative autologous materials could enable tracheal replacement.
Area of Science:
- Biomedical Engineering
- Surgical Innovation
- Veterinary Science
Background:
- Tracheal defects pose significant reconstructive challenges.
- Current tracheal replacement methods have limitations.
- Investigating autologous tissues for tracheal substitution is crucial.
Purpose of the Study:
- To evaluate the feasibility of using autologous esophageal segments with expandable metallic stents (EMS) as tracheal substitutes.
- To assess the long-term patency and integration of esophageal tracheal grafts in a canine model.
Main Methods:
- Surgical interposition of pedicled esophageal segments with EMS to replace resected cervical tracheal segments in six dogs.
- Endoscopic monitoring of the graft throughout the study period.
- Postmortem examination to assess graft integration and complications.
Main Results:
- Expandable metallic stents (EMS) became embedded in the esophageal mucosa within 1 month, maintaining lumen patency.
- All canine subjects survived for extended periods (5-478 days) without detected respiratory complications.
- No definitive cause of death was identified in postmortem examinations.
Conclusions:
- Autologous esophageal segments supported by EMS demonstrate potential as reliable tracheal substitutes.
- While direct clinical application is limited, the study validates the concept of using supported autologous materials for tracheal reconstruction.
- Further research into alternative autologous materials for tracheal replacement is warranted.