کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4304018 | 1288493 | 2008 | 4 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Tracheal Reconstruction by Esophageal Submuscular Tunneling: An Experimental Study Tracheal Reconstruction by Esophageal Submuscular Tunneling: An Experimental Study](/preview/png/4304018.png)
BackgroundThe problem of how to treat large tracheal lesions remains a challenge in surgery. To reconstruct a long tracheal defect, a safe method other than end-to-end anastomosis is necessary.Materials and methodsIn 14 adult cross-breed dogs, a segment of trachea including seven tracheal rings was dissected and resected circumferentially. A submuscular tunnel was induced between mucosal and muscular layers of the adjacent esophagus lying right next to the trachea. An endotracheal tube was inserted between the tracheal rings 2 and 3. Then it was passed cautiously through the esophageal submuscular tunnel and through the distal tracheal segment. The proximal and distal ends of the esophageal tunnel and trachea were approximated and anastamosed. The animals were extubated 10 days after the operation.ResultsAll dogs tolerated the surgical procedure well. The first two dogs experienced postoperative fever, tracheoesophageal fistula, aspiration pneumonia, and sepsis so hard bony components were omitted from diet. All survived animals were eating and barking well. The submuscular esophageal tunnel was patent in all animals. The new lumen was supported externally with fibrous connective tissue. The tunnelized area was covered completely with pseudostratified ciliated epithelium.ConclusionDue to formation of fibrous tissue between skeletal muscular structures of the neck and the external layer of the tunnelized esophagus, the new airway remained patent. Overall, air tightness, good reepithelialization, and relatively no limitation of esophageal length are the advantages of tracheal reconstruction by submuscular esophageal tunneling. This new method is worthy of further investigation, as it is technically feasible and easy to implement.
Journal: Journal of Surgical Research - Volume 150, Issue 1, November 2008, Pages 74–77