Experimental study of replacing circumferential tracheal defects with new prosthesis.

PURPOSE: To investigate the feasibility of using a new tracheal prosthesis made of biomaterials to replace extensive circumferential tracheal defects.

DESCRIPTION: Three types of tracheal prostheses were developed and studied. Type I prosthesis was used in 8 mongrel dogs (group A), type II in 4 dogs (group B), and type III in 4 dogs (group C).

EVALUATION: In group A, one died from prosthetic dehiscence, another from anastomotic leakage, and the others had uneventful postoperative courses. The implanted prosthesis was completely incorporated with the recipient trachea, where different lengths of reepithelialization occurred on the luminal surface of the reconstructed trachea. Macroscopic examination showed scattered and different sizes of neo-ossification surrounding the implanted prosthesis. The prosthesis was radioopaque when exposed to routine x rays. In contrast, a relatively high number of complications occurred postoperatively in groups B and C.

CONCLUSIONS

Type I tracheal prosthesis, with further improvements, may be the optimal tracheal graft to replace circumferential tracheal defects, and appears very promising for clinical application.