Tracheal reconstruction using a free jejunal flap with cartilage skeleton: experimental study

Area of Science:

• Regenerative Medicine
• Surgical Innovation
• Biomaterials Science

Background:

• Tracheal defects pose significant reconstructive challenges.
• Current methods for major tracheal reconstruction have limitations.
• Autologous tissues offer potential for biocompatible reconstruction.

Purpose of the Study:

• To evaluate the efficacy of autologous microvascular jejunal transfer with a cartilage skeleton for large tracheal defect reconstruction.
• To assess the long-term stability and functional outcomes of this reconstructive technique in a goat model.

Main Methods:

• A 15-cm cervical tracheal segment was replaced using a free microvascular jejunal transfer with a costal cartilage skeleton in goats.
• The graft was stented with an endotracheal T-tube for 4 weeks.
• Survivors underwent bronchoscopy at 6 months, with histological analysis.

Main Results:

• A 30% survival rate was achieved at the 30-week follow-up.
• Bronchoscopy revealed a smooth, patent airway lumen.
• Histology confirmed hyaline cartilage integration and normal jejunal mucosa.

Conclusions:

• Autologous microvascular jejunal transfer with a cartilage skeleton provides a stable reconstruction for large circumferential tracheal defects.
• This technique demonstrates promising long-term patency and asymptomatic function in surviving animals.
• Further research may explore its clinical applicability in human tracheal reconstruction.