[Experimental reconstruction of the canine trachea with shape-memory titanium-nickel alloy stent coupled with free jejunal graft].
OBJECTIVE
To explore the reconstruction method of extensive circumferential tracheal defects longer than 6.0 cm and evaluate the influence on pulmonary function from jejunal secretion.


METHODS
Jejunal secretion model without extraneous nerve were established. 10 mongrel dogs were randomly divided into two groups. In group A, the nude stent made by shape-memory titanium-nickel alloy (SMA stent) was placed in the interior of the intestinal lumen. In group B, the SMA stent with silicone membrane was placed in the interior of the intestinal lumen. The secretion and histological chance of these jejunal were observed regularly. The cervical tracheal segment (6.5 cm) was replaced by the intestinal graft. In group C (6 mongrel dogs), the nude stent made by SMA stent was placed in the interior of the intestinal lumen. In group D (6 mongrel dogs and 6 Beagle dogs), the SMA stent with silicone membrane was placed in the interior of the intestinal lumen, the nude "C-shaped" SMA stent was placed out of the intestinal lumen, and the silicone stent was removed the fourth week after operation. In group C and group D, endoscopic and histological examinations were performed between the first week and eighth month.


RESULTS
The secretory peak of Jejunal secretion model without extraneous nerve ranged from the first day to seventh day after operation. The jejunal secretion reduced gradually from 7th days after operation. The jejunal secretion remained steady after postoperative two months. In group C, endoscopic examination showed heavy proliferation of granulation in the tracheo-intestinal anastomosis. 4 dogs died between seventh day to second month. In group D, one dog died from ileus third month after operation. The other all survived operation. Gentle pneumonia happened to some dogs during 1-2 months after operation by X-ray examination. No one died of pneumonia result from hypersecretion.


CONCLUSIONS
Reconstruction of the canine trachea with SMA stent with silicone membrane placed in the interior of the intestinal lumen together with the nude "C-shaped" SMA stent placed out of the intestinal lumen achieve satisfactory effect, the reconstructed trachea remain unblocked and this method of tracheal reconstruction may be relatively perfect and be expected for clinical application in future. The jejunal secretion didn't have severe influence on pulmonary function of experimental canine and couldn't cause experimental canine death.
Ma
Ling-guo
LG
Department of Otorhinolaryngology-Head and Neck Surgery, First People's Hospital of Foshan, Foshan City, Guangdong 528000, China. ljymax@yahoo.com.cn
Wang
Yue-jian
YJ
He
Fa-yao
FY
Zhang
Jian-li
JL
Zhou
Xing
X
D000497:Alloys; D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D009532:Nickel; D016377:Organ Transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D015607:Stents; D014025:Titanium; D014132:Trachea / Q000601:surgery*
D000497:Alloys; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium