EXPERIMENTAL STUDY OF A NEW TRACHEAL PROSTHESIS MADE FROM COLLAGEN-GRAFTED MESH; INVESTIGATION OF APPLICATION TO INTRATHORACIC TRACHEAL REPLACEMENT

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We carried out intrathoracic tracheal replacement in dogs using our original tracheal prosthesis made from mesh. The prosthesis consists of Marlex® mesh (polypropylene) reinforced with a continuous polypro-pylene spiral, and is grafted and coated with pig collagen. Complete surgical resection of the mediastinal trachea was performed in 6 adult mongrel dogs. In one dog, a 4-tracheal-ring segment (2cm) was resected and replaced with a 3-cm-long prosthesis, and in 5 dogs, a 7-to 8-tracheal-ring segment (4cm) was resected and replaced with a 5-cm-long prosthesis. In the latter 5 dogs, a silicone tube was temporarily inserted into the replacement, and removed by bronchoscopy one month after surgery. The prostheses in all dogs were promptly infiltrated by surrounding tissue and completely incorporated by the host trachea. No dehiscence or air leakage was observed after surgery. Mild luminal stenosis was evident in one dog, and partial exposure of the mesh (ulceration) was observed in 5 dogs within an observation period of 4 to 26 months. Formation of respiratory epithelium, which lined the prosthetic lumen, was seen to various degrees, and in the dog which received the 2-cm-long replacement, epithelization was confirmed histologically from the upper to the lower anastomosis of the prosthesis. We conclude that our tracheal prosthesis is useful for the repair of intrathoracic tracheal defects and shows promise for clinical application.
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EXPERIMENTAL STUDY OF A NEW TRACHEAL PROSTHESIS MADE FROM COLLAGEN-GRAFTED MESH; INVESTIGATION OF APPLICATION TO INTRATHORACIC TRACHEAL REPLACEMENT

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