Influence of suture material and technique on end-to-end reconstruction in tracheal surgery: an experimental study in sheep.
Resection and end-to-end anastomosis of the trachea represent the preferred treatment for various benign and malignant diseases involving the trachea. Various studies have reported conflicting results with alternative techniques and suture materials for tracheal anastomosis. Our objective was to evaluate three frequently used techniques concerning stenosis rate and histological reaction in a large-animal species. Tracheal resection of 3 cm and end-to-end anastomosis were performed in 15 sheep with the use of three different techniques. In the first group, an interrupted suture with polyglactin, in the second group an interrupted suture with polydioxanone, and in the last group a continuous suture with polypropylene were used. The animals were killed 1, 2, 4, 8, and 24 weeks postoperatively. The luminal stenosis was determined by means of computerized planimetry. All three techniques appeared to be appropriate for tracheal anastomosis. The luminal stenosis developed within the first 8 weeks after surgery. A cross-sectional area of approximately 40-70% was finally achieved. Differences dependent on the suture material are less important than the technical details of the operation.
Behrend
M
M
Klinik für Viszeral- und Transplantationschirurgie, Hannover, Germany. behrend.matthias@mh-hannover.de
Klempnauer
J
J
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D001777:Blood Coagulation; D005260:Female; D005337:Fibrin; D016687:Polydioxanone; D011098:Polyglactin 910; D011126:Polypropylenes; D020545:Respiratory Mucosa / Q000473:pathology; D012756:Sheep; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures / Q000009:adverse effects; D013718:Tensile Strength; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014135:Tracheal Stenosis / Q000209:etiology / Q000473:pathology
D011126:Polypropylenes; D016687:Polydioxanone; D011098:Polyglactin 910; D005337:Fibrin