Abstract
A new model of artificial trachea has been tested. A cylinder made of knitted dacron, 5cm in length and 18mm or 20mm in diameter, was inner-coated with silicone rubber, at both ends, for a distance of 5mm in length, coating was not performed to leave them flexible for anastomosis. Fibroblasts, cultured from the skin of a mongrel dog, were suspended in a fibrin-glue solution, and coated onto the inner surfaces of the flexible ends of the dacron tube. Eleven dogs underwent mediastinal tracheal replacement by this hybrid artificial trachea graft through a right thoracotomy. The patency rate (area of the cut surface of a patent anastomotic ring/ area of the cut surface of the graft)(%) was measured regularly after surgery, through bronchoscopy or autopsy. The average patency rates at oral anastomotic sites was 80.5±23%(n=10) at 2 months after operation, 71.3±25.1%(n=7) at 3 months, and 68.9±34.3%(n=4) at 4 months. The caudal anastomotitic sites showed similar patency rates. Growth of granulation tissue at anastomotic rings was significantly less and slower in the experimental group than in the first model of hybrid artificial trachea in our laboratory, which had been prepared by fibrinogen and a scanty amount of fibroblasts. Seven out of 11 dogs are alive in good condition to date, from 2 to 7 months after surgery. Histological examination of the inner surface of the anastomotic sites of a graft in one dog at 7 months after surgery, revealed squamous epithelial lining on the surface of only a thin layer of granulation tissue. Although this favorable result has been brought about by both fibrin-glue and fibroblasts, I feel that the greater number of fibroblasts in this series are mainly responsible for the better results.
