Animal Experiment Of Tracheal Nitinol Stent Covered With Autologous Pericardium To Repair Long Segmental Tracheal Defect

Background: End to end anastomosis after airway lesion resection is the best way of surgical treatment of tracheal stenosis. Because of the limited length of the trachea, the tension by anastomosis after overrun resection is too big to fail, so we need prosthesis for transplantation. Objective: To explore the feasibility of tracheal nitinol stent covered with autologous pericardium to repair long segmental tracheal defect. Method: 10 experimental bama miniature pigs with small range of weight(24.7±3.0)kg. Intercepted part of autologous pericardium and trimmed it into 7*6cm-size. Then coated it on the tracheal nitinol stent and made of artificial trachea. Dissociated the cricoid cartilage and a enough length of the tracheal in neck. Resected 6cm of tracheal from the third tracheal tube ring below the cricoid cartilage. Put another endotracheal tube into the proximal end of trachea. Suture the distal end of tracheal and artificial trachea which made of tracheal nitinol stent covered with autologous pericardium by absorbable suture. The proximal end was sutured from the rear wall remove the endotracheal tube when there was 1/3 left. Then sutured the remaining part and complete the reconstruction of tracheal defects. Observe the general situation and short-term quality of living postoperative. Assess the possibility of long-term survival based on the above results. Made a bronchoscopy at the 30 d postoperative and did it again every 30 ds later. Observed whether there was displacement, deformation of the artificial trachea, and if there were luminal hyperplasia, stenosis, new epithelial. Take normal tracheal tissue proliferation, newborn tissue to do pathological examination. Result: There is no intraoperative death. 1 pig died in the 12 d for split anastomotic bleeding after surgery. 6 pigs died in 2~5 month caused by artificial endotracheal hyperplasia, narrow sputum deposition after surgery. 3 of them lived to 8 months after surgery. Bronchoscopy after surgery: All pigs were mild anastomotic stenosis, hyperplasia of artificial airway in central cavity stenosis, autopsy pathology confirmed of fiber connective tissue hyperplasia. Average length of new epithelial was 1, 4, 6, 8, 10, 12, 13, 13 mm in 1 ~ 8 month after surgery. Conclusion: Tracheal nitinol stent covered with autologous pericardium to repair long segmental tracheal defect could ensure the survival of animals in the short term. Artificial trachea central stenosis caused by fibrous connective tissue hyperplasia was still the main influence factor of long-term survival.