Tracheal regeneration after partial resection: a tissue engineering approach.
OBJECTIVE
The aims of this study are to investigate the efficiency of a tissue engineering approach to partial tracheal reconstruction and to improve epithelialization of the reconstructed trachea. The trachea must be resected in some cases of cancer or trauma. Various restructuring techniques are used, with no consensus on the best approach. Two problems that arise when treating tracheal defects by conventional techniques are an inability to regenerate ciliated epithelium at the reconstructed site and having to perform multiple procedures to achieve the desired repair. This study is designed to address these problems.


METHODS
Preliminary, an animal experiment.


METHODS
Surgery was performed on five adult beagles under anesthesia. After the making of a longitudinal cervical skin incision, the trachea was exposed and a circular defect created. A polypropylene and collagen scaffold preclotted with peripheral blood was inserted to the defect site. Postoperatively, the site was evaluated fiberscopically, histologically, and radiographically.


RESULTS
All dogs did well postoperatively. Fiberscopic examination showed that the implanted scaffolds were completely covered with regenerated mucosa with capillaries in all cases. Histologic data showed ciliated epithelium regenerated at the operated site from 1 month postoperatively. Newly formed cartilage was detected in the specimens from 8 to 12 postoperative months. Computed tomography images revealed the fine luminal contour of the regenerated site.


CONCLUSIONS
Good epithelial regeneration was observed after repair of a round tracheal resection using a simple tissue engineering technique, making the technique a good substitute for conventional approaches to tracheal reconstruction in patients with cancer or trauma.
Yamashita
Masaru
M
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kanemaru
Shin-ichi
S
Hirano
Shigeru
S
Magrufov
Akhmar
A
Tamaki
Hisanobu
H
Tamura
Yoshihiro
Y
Kishimoto
Masanao
M
Omori
Koichi
K
Nakamura
Tatsuo
T
Ito
Juichi
J
D000818:Animals; D001999:Bronchoscopy; D003094:Collagen; D004285:Dogs; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D011126:Polypropylenes; D019919:Prosthesis Implantation / Q000295:instrumentation; D019651:Plastic Surgery Procedures; D020545:Respiratory Mucosa / Q000166:cytology / Q000502:physiology; D023822:Tissue Engineering / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery; D014945:Wound Healing / Q000502:physiology*
D011126:Polypropylenes; D003094:Collagen