[Metaplasia of aortic tissue into tracheal tissue. Surgical perspectives].
Tracheal reconstruction after extensive resection remains an unsolved surgical problem. Numerous attempts have been made using tracheal grafts or prosthetic conduits with disappointing results. In this study, we propose a new alternative using an aortic autograft as tracheal substitute. In a first series of experiments, a half circumference of two rings was replaced with an autologous carotid artery patch. In a second series, a complete segment of trachea was replaced with an autologous aortic graft supported by an endoluminal tracheal stent. No dehiscence or stenosis was observed. Microscopic examinations at 3 and 6 months showed the replacement of the aortic tissue by tracheal tissue comprising neoformation of cartilage and mucociliary or non-keratinizing metaplastic polystratified squamous epithelium. Although these results need to be confirmed by a larger series of experiments, they showed that a vascular tissue placed in a different environment with a different function can be submitted to a metaplastic transformation which tends to restore a normal structure adapted to its new function. These remarkable findings offer new perspectives in tracheal reconstruction in human.
Martinod
E
E
Laboratoire d'étude des greffes et prothèses cardiaques, Hôpital Broussais, Paris, France.
Zakine
G
G
Fornes
P
P
Zegdi
R
R
d'Audiffret
A
A
Aupecle
B
B
Goussef
N
N
Azorin
J
J
Chachques
J C
JC
Fabiani
J N
JN
Carpentier
A
A
D000818:Animals; D001013:Aorta, Thoracic / Q000473:pathology / Q000637:transplantation*; D002339:Carotid Arteries / Q000473:pathology / Q000637:transplantation; D002356:Cartilage / Q000473:pathology; D002454:Cell Differentiation; D002465:Cell Movement; D002923:Cilia / Q000648:ultrastructure; D004417:Dyspnea / Q000209:etiology; D004848:Epithelium / Q000473:pathology; D006099:Granuloma / Q000209:etiology; D008679:Metaplasia; D011183:Postoperative Complications; D012756:Sheep; D015607:Stents; D013529:Surgical Wound Dehiscence; D014132:Trachea / Q000601:surgery*; D014182:Transplantation, Autologous; D016042:Transplantation, Heterotopic; D014945:Wound Healing
Métaplasie de tissu aortique en tissu trachéal. Perspectives chirurgicales.