An Experimental Study Of Polypropylene Combined With Surgical Flap In Reconstruction Of The Trachea

Objective: To make an artificial trachea, which can really heal with native trachea.Method: About 3.5 to 4 centimeter cervical trachea was resected and replaced with artificial trachea made from Monofilament Knitted Polypropylene and surgical flap. Covered stent was implanted in early period of postoperation. During survival period, quality and stenosis of anastomosis were recorded. X-ray film and tracheal fiberscopy were operated at 2, 4, 8 weeks and 6 months postsurgery. The stent was taken out with fiberscope first at 8 weeks postsurgery, and was gradually decreased to 2 weeks postsurgery. The animals were sacrificed and the tracheae were examined at 2, 4, 8 weeks and 6 months postsurgery.Results: Six dogs survived well and another two died. The causes of death were respiratory failure in 1 and infection in another 1. Slight stenosis occurred in 1 dog during survival period. The dogs were free of drinking and eating on the second postoperative day, no dyspnea was found. There was pelage appeared in the tracheal cavity from 4 weeks postsurgery. The pelage was longer at 6 months postsurgery , but it did not impacted the breath and the expulsion of sputum. The artificial tracheae and the stents were normal on X-ray films at 8 weeks postsurgery. The dogs survived well after the stents were taken out. The artificial tracheae were normal on X-ray films at 6 months postsurgery, the pulmonary markings were clear. The animals were sacrificed at 2, 4, 8 weeks and 6 months postsurgery. Soft tissue was found in the mesh at 2 weeks postsurgery and more at 4 weeks. The whole mesh was covered by soft tissue at 8 weeks and 6 months postsurgery. the hardness and sustentation degree were enhanced following the growth and fibrosis of soft tissue. The squamous epithelium and columnar epithelium were observed healing well by HE staining method.Conclusion: One-stage operative artificial trachea made from Monofilament Knitted Polypropylene and surgical flap is the closer artificial trachea to native trachea. It has a promising prospect in clinical use.