Use of Autologous Bronchial Cartilage to Repair an Intraoperative Bronchial Airway Defect After Pneumonectomy for Lung Mesothelioma

Abstract

Tracheobronchial defects may occur intraoperatively because of surgical trauma after resection of thoracic tumors. The repair of large, circumferential tracheobronchial defects with tissue loss may pose a major challenge. In an effort to solve this problem, different techniques have been used with little success. Attempts with foreign materials, nonviable tissues, autogenous noncartilaginous tissues, tissue engineering, and allotransplantation have all been associated with disappointing or suboptimal results. In each category, biologic problems are noted. Hence, the reconstruction and substitution of large, circumferential tracheobronchial defects has so far remained an unsolved surgical dilemma. We report a unique case in which an airway defect in the bronchus, made inadvertently intraoperatively, was repaired using autologous bronchial cartilage obtained from the resected specimen. In the literature, autologous bronchial cartilage has never been used before in reconstructing a large tracheobronchial defect.