Releasing tension on a tracheal anastomosis: an ex vivo study on a sheep model.
OBJECTIVE
Tension is the limiting factor in long tracheal resection with end-to-end anastomosis. Complications such as dehiscence and restenosis are well correlated with the degree of anastomotic tension. The objective of our study was to investigate the effects of patches of auricular cartilage glued craniocaudally along a tracheal anastomosis.


METHODS
Rupture tests were performed on sheep tracheas collected from a slaughterhouse. In group A (n = 5), 3 patches of auricular cartilage of 0.5 x 5 cm were glued with albumin-glutaraldehyde tissue adhesive (BioGlue) craniocaudally along the left, right, and anterior borders of the transected tracheas. In group B (n = 10), the patches were fixed with 2 transparietal intercartilaginous stitches without adhesive. In group C (n = 10), adhesive and stitches were used.


RESULTS
Three patches of cartilage glued along the tracheal anastomosis held tension as high as 11.1 N. Adhesive maintained the tracheal extremities in closer contact than did stitches alone. It increased the anastomotic resistance strength (50.8 N in group C versus 29.6 N in group B). This increase was statistically significant.


CONCLUSIONS
Gluing auricular cartilage patches along ex vivo tracheal anastomoses strengthened them and helped diminish tension on the suture line.
Zaugg
Yannick
Y
Department of Otolaryngology-Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Cuffel
Cyril
C
Monnier
Philippe
P
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002356:Cartilage / Q000601:surgery; D012756:Sheep; D013536:Suture Techniques; D013718:Tensile Strength; D014014:Tissue Adhesives; D014132:Trachea / Q000503:physiopathology / Q000601:surgery*; D014140:Tracheotomy
D014014:Tissue Adhesives