Comparison of different methods of circumferential tracheal reconstruction: an experimental study

Year 2007, Volume: 17 Issue: 3, 158 - 166, 23.05.2007

Ayhan Okumuş Orhan Çizmeci Samet Vasfi Kuvat Fatih Kabakaş Ayaz Aslanov Bülent Yaprak Erdem Güven Günter Hafız

Abstract

Objectives: This study was designed to compare different prefabrication models for circumferential tracheal reconstruction.Materials and Methods: Thirty adult female New Zealand rabbits were divided into six groups for circum­ ferential tracheal reconstruction with a different tissue combination. Prefabrication of neotrachea was per- formed without anastomosis. Lateral thoracic fascia or pectoralis majör muscle were used for vascular supply.Polypropylene mesh, polytetrafluoroethylene Gore- Tex , or cartilage rings were used for skeletal frame- work. Hairless epithelial skin graft was used for inner lin- ing. The groups were compared in terms of viability of hairless epithelial graft, longitudinal flexibility, rigidity, flap wall thickness, internal diameter, and flap viability.Results: Epithelial skin graft was almost totally viable 95%-99% in the polypropylene mesh groups. Gore-Tex groups exhibited almost total necrosis 74%-71% . Longitudinal flexibility and rigidity were similar to the native trachea in Gore-Tex and polypropylene mesh groups. Neotrachea pre- fabricated with cartilage grafts showed more than normal longitudinal flexibility and collapsed easily.Conclusion: The prefabricated model with the use of polypropylene mesh for skeletal framework and lateral thoracic fascia for vascular supply seems to be the best alternative in the reconstruction of circumferential tra­ cheal defects.

Keywords

Bioprosthesis, epithelium/transplantation, graft survival, rabbits, surgical flaps, trachea/surgery

Sirküler trakeal rekonstrüksiyonda farklı yöntemlerin karşılaştırılması: Deneysel çalışma

Abstract

Amaç: Bu çalışmada sirküler trakeal rekonstrüksiyon için farklı prefabrike modellerin karşılaştırılmasıamaçlandı.Gereç ve Yöntem: Otuz adet erişkin dişi Yeni Zelanda tavşanı, farklı doku kombinasyonuyla sirkülertrakeal rekonstrüksiyon için altı gruba ayrıldı. Prefabrike edilmiş trakealarda anastomoz yapılmadı.Vasküler kaynak olarak lateral torasik fasya veyapektoralis majör kası; iskeletsel çatı olarak polipropilen mesh, politetrafloroetilen Gore-Tex veya yüzük kartilajlar kullanıldı. İç yüzey tüysüz epitelyalderi greftinden sağlandı. Gruplar tüysüz epitel greftinin canlılığı, longitüdinal esneklik, dayanıklılık,flep duvar kalınlığı, iç çap ve flep canlılığı açısından karşılaştırıldı.Bulgular: Polipropilen mesh gruplarında tama yakınepitelyal deri grefti canlılığı görülürken %95-%99 ,Gore-Tex gruplarında tama yakın nekroz gözlendi %74-%71 . Longitüdinal esneklik ve dayanıklılık Gore-Tex ve polipropilen mesh gruplarında normal trakeaya yakın ölçülerde bulundu. Kartilaj greftleri ileprefabrikasyon yapılan gruplar normalden fazla longitüdinal esneklik ve kolayca kollaps gösterdi.Sonuç: İskeletsel çatı olarak polipropilen mesh, vasküler kaynak olarak lateral torasik fasyanın kullanıldığı prefabrike model, sirküler trakea defektlerinin rekonstrüksiyonunda en iyi seçenek olarak görünmektedir

Keywords

Biyoprotez, epitel/transplantasyon, greftcanlılığı, tavşan, cerrahi flep, trakea/cerrahi

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