H. Yokomise, MDa, K. Inui, MDa, H. Wada, MDa, M. Ueda, MDa, S

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Presentation transcript:

Split transplantation of the trachea: A new operative procedure for extended tracheal resection H. Yokomise, MDa, K. Inui, MDa, H. Wada, MDa, M. Ueda, MDa, S. Hitomi, MDa, H. Itoh, MDb The Journal of Thoracic and Cardiovascular Surgery Volume 112, Issue 2, Pages 314-318 (August 1996) DOI: 10.1016/S0022-5223(96)70256-8 Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Diagram of split tracheal transplantation. A, Ten-ring length of trachea is autotransplanted. Grafts are divided at midportion and four to five 4-0 polypropylene sutures are placed through two halves of grafts and omentum. B, Omentum is inserted between two halves of grafts, and midportion is sutured. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Bronchoscopic (A) and macroscopic (B) findings 158 days after split tracheal transplantation. There is no stenosis at any anastomotic site (arrowheads) or in graft. There is no evidence of atrophy in graft. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Bronchoscopic (A) and macroscopic (B) findings 158 days after split tracheal transplantation. There is no stenosis at any anastomotic site (arrowheads) or in graft. There is no evidence of atrophy in graft. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Macroscopic findings 7 days after transplantation in animal from control group. Graft shows definite ischemic changes. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 Histologic findings after split transplantation. Viability of epithelium and cartilage is preserved. At midportion of graft neovascularization (arrowheads) has been facilitated by inserted omentum. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 A, Microangiogram of trachea 158 days after split transplantation. Abundant neovascularization of graft is present at all three anastomotic sites (arrowheads). B, Microangiogram of trachea from animal in control group 158 days after transplantation. Neovascularization is poor in midportion of graft. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 A, Microangiogram of trachea 158 days after split transplantation. Abundant neovascularization of graft is present at all three anastomotic sites (arrowheads). B, Microangiogram of trachea from animal in control group 158 days after transplantation. Neovascularization is poor in midportion of graft. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 314-318DOI: (10.1016/S0022-5223(96)70256-8) Copyright © 1996 Mosby, Inc. Terms and Conditions