title: [Trachea repair and reconstruction with new composite artificial trachea transplantation].
abstract: OBJECTIVE
  To construct a new composite artificial trachea and to investigate the feasibility of trachea repair and reconstruction with the new composite artificial trachea transplantation in dogs.
  
  
  METHODS
  The basic skeleton of the new composite artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings at both ends. Dualmesh was sutured on titanium rings. Sixteen dogs, weighing (14.9 +/- 2.0) kg, female or male, were selected. The 5 cm cervical trachea was resected to prepare the cervical trachea defect model. The trachea repair and reconstruction was performed with the new composite artificial trachea. Then fiberoptic bronchoscope examination, CT scan and three-dimensinal reconstruction were conducted at immediate, 1 month, and 6 months after operation. Gross observation and histological examination were conducted at 14 months to evaluate the repair and reconstruction efficacy.
  
  
  RESULTS
  No dog died during operation of trachea reconstruction. One dog died of dyspnea at 37, 41, 55, 66, 140, and 274 days respectively because of anastomotic dehiscence and artificial trachea displacement; the other 10 dogs survived until 14 months. The fiberoptic bronchoscope examination, CT scan and three-dimensinal reconstruction showed that artificial tracheas were all in good location without twisting at immediate after operation; mild stenosis occurred and anastomoses had slight granulation in 6 dogs at 1 month; severe stenosis developed and anastomosis had more granulation in 1 dog and the other dogs were well alive without anastomotic stenosis at 6 months. At 14 months, gross observation revealed that outer surface of the artificial trachea were encapsulated by fibrous connective tissue in all of 10 dogs. Histological examination showed inflammatory infiltration and hyperplasia of fibrous tissue and no epithelium growth on the inner wall of the artificial trachea.
  
  
  CONCLUSIONS
  The new composite artificial trachea can be used to repair and reconstruct defect of the trachea for a short-term. Anastomotic infection and dehiscence are major complications and problems affecting long survival.
authors.affiliation: Department of Thoracic Surgery, Second Xiangya Hospital, Central South University, Changsha Hunan, 410011, P.R. China.
authors.forename: Wenliang
authors.initials: W
authors.lastname: Liu
authors.forename: Peng
authors.initials: P
authors.lastname: Xiao
authors.forename: Hengxing
authors.initials: H
authors.lastname: Liang
authors.forename: Ran
authors.initials: R
authors.lastname: An
authors.forename: Gang
authors.initials: G
authors.lastname: Cheng
authors.forename: Fenglei
authors.initials: F
authors.lastname: Yu
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001672:Biocompatible Materials; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D008297:Male; D011138:Polytetrafluoroethylene; D016062:Porosity; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D023822:Tissue Engineering; D014025:Titanium; D014132:Trachea / Q000473:pathology / Q000601:surgery*
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene; D014025:Titanium