Abstract
An experimental study was conducted to investigate whether a segment of autogenous esophagus with its lumen supported by an expandable metallic stent (EMS) could be successfully used as a tracheal substitute. Seven rings of the cervical trachea were circumferentially removed and reconstructed by interposing a pedicled segment of the esophagus with an EMS in six mongrel dogs. The interposed esophagus was observed endoscopically at various stages after the operation. By 1 month, the EMS was found to be buried under the esophageal mucosa, and the lumen was patent. The dogs died 5, 17, 61, 92, 210, and 478 days after the operation, but the cause of death could not be determined by postmortem examination and no respiratory tract complications were detected. The results of this study indicated that a segment of the esophagus with its lumen supported by an EMS could work as a reliable tracheal substitute, though its practical use is not clinically feasible. Nevertheless, we conclude that some autogenous material other than the esophagus with its lumen supported by an EMS could provide a feasible method for tracheal replacement.
Similar content being viewed by others
References
Grillo HC (1989) Notes on the windpipe. Ann Thorac Surg 47:9–26
Letang E, Sanchez-Lloret J, Gimferrer JM, Ramirez J, Vicens A (1990) Experimental reconstruction of the canine trachea with a free revascularized small bowel graft. Ann Thorac Surg 49:955–958
Papp C, MacCraw JB, Arnold PG (1985) Experimental reconstruction of the trachea with autogenous materials. J Thorac Cardiovasc Surg 90:13–20
Eckersberger F, Moritz E, Wolner E (1987) Circumferential tracheal replacement with costal cartilage. J Thorac Cardiovasc Surg 94:175–180
Khalil-Marzouk JF (1993) Allograft replacement of the trachea. J Thorac Cardiovasc Surg 105:242–246
Mendak SH Jr, Jensik R, Haklin MF, Roseman DL (1984) The evaluation of various bioabsorbable materials on the titanium fiber metal tracheal prosthesis. Ann Thorac Surg 38:488–493
Cull DL, Lally KP, Mair EA, Daidone M, Parsons DS (1990) Tracheal reconstruction with polytetrafluoroethylene graft in dogs. Ann Thorac Surg 50:899–901
Fonkalsrud EW, Martelle RR, Maloney JV Jr (1963) Surgical treatment of tracheal agenesis. J Thorac Cardiovasc Surg 45:520–525
Fonkalsrud EW, Sumida S (1971) Tracheal replacement with autologous esophagus for tracheal stricture. Arch Surg 102:139–142
Akl BF, Yabek SM, Berman W Jr (1984) Total tracheal reconstruction in a three-month-old infant. J Thorac Cardiovasc Surg 87:543–546
Fleischer A, Kahafif R (1989) Reconstruction of the mediastinal trachea with a tubed pectoralis major myocutaneous flap. Plast Reconst Surg 84:342–346
Yamada A, Harii K, Itoh Y, Kikawada T, Miyashita H (1993) Reconstruction of the cervical trachea with a free forearm flap. Br J Plast Surg 46:32–35
Neville WE, Bolanowski PJP, Kotia GG (1990) Clinical experience with silicone tracheal prosthesis. J Thorac Cardiovasc Surg 99:604–613
Wallace MJ, Charnsangavej C, Ogawa K, Carrasco CH, Wright KC, McKenna R, McMurtrey M, Gianturco C (1986) Tracheobronchial tree: expandable metallic stents used in experimental and clinical application. Radiology 158:309–312
Kato R, Onuki AS, Watanabe M, Hashizume T, Kawamura M, Kikuchi K, Kobayashi K, Ishihara T (1990) Tracheal reconstruction by esophageal interposition: An experimental study. Ann Thorac Surg 49:951–954
Grillo HC (1990) Tracheal replacement. Ann Thorac Surg 49:864
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kato, R., Eguchi, K., Izumi, Y. et al. Experimental tracheal replacement using the esophagus and an expandable metallic stent. Surg Today 25, 806–810 (1995). https://doi.org/10.1007/BF00311457
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00311457