Tracheal reconstruction with porous high-density polyethylene tracheal prosthesis.

Abstract

The variety of methods used for the treatment of severe tracheal stenosis and the occasional failure to obtain lasting and consistent relief are measures of the difficulty of the problem. Presently, several surgical approaches are used for reconstructing large defects of the cervical trachea, reminding us that no single technique has gained wide clinical acceptance. We resected a U-shaped cartilage from 6 to 8 rings of the trachea of 10 New Zealand rabbits. We used a porous high-density polyethylene (PHDP) prosthesis to reconstruct the cervical trachea, and did not perform a tracheotomy during this operation. We followed up the rabbits for 4 to 10 months. One of the rabbits died in the second month because of respiratory distress; another was lost in the fourth month of the study while delivering young. The others continued to thrive; in fact, one of them gave birth 3 times after our study and was well able to take care of her young. At the end of the study, the rabbits were painlessly sacrificed in order to remove the larynx and trachea and examine them histopathologically. In the histopathologic examinations, the prostheses were incorporated into the native trachea and adhered to the surrounding organs, especially to the esophagus. No mucosal irregularities were seen on the surface of the prosthesis, and all the surfaces appeared to be covered with ciliated pseudostratified epithelium. This tracheal prosthesis provides good results in rabbit tracheal reconstruction, and appears very promising for the clinical repair of tracheal defects.