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Intrathoracic tracheal reconstruction with a collagen-conjugated prosthesis: Evaluation of the efficacy of omental wrapping  Masayoshi Teramachi, MDa,

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Presentation on theme: "Intrathoracic tracheal reconstruction with a collagen-conjugated prosthesis: Evaluation of the efficacy of omental wrapping  Masayoshi Teramachi, MDa,"— Presentation transcript:

1 Intrathoracic tracheal reconstruction with a collagen-conjugated prosthesis: Evaluation of the efficacy of omental wrapping  Masayoshi Teramachi, MDa, Norihito Okumura, MDa, Tatsuo Nakamura, MDa, Yasumichi Yamamoto, MDa, Tetsuya Kiyotani, MDa, Yukinobu Takimoto, MDa, Shojiro Matsuda, MAgb, Yoshito Ikada, PhDb, Yasuhiko Shimizu, MDa  The Journal of Thoracic and Cardiovascular Surgery  Volume 113, Issue 4, Pages (April 1997) DOI: /S (97) Copyright © 1997 Mosby, Inc. Terms and Conditions

2 Fig. 1 Tracheal prosthesis. The mesh cylinder is reinforced with a continuous polypropylene spiral (top), then conjugated and coated with collagen (bottom). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

3 Fig. 2 A photograph taken after completion of tracheal reconstruction is shown at the top; at the bottom is a schema of the tracheal reconstruction. A silicone drainage tube is inserted into the prosthetic lumen. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

4 Fig. 2 A photograph taken after completion of tracheal reconstruction is shown at the top; at the bottom is a schema of the tracheal reconstruction. A silicone drainage tube is inserted into the prosthetic lumen. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

5 Fig. 3 Luminal surface of the prosthesis is completely covered with host tissue in a dog of the omentopexy group after 6 months. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

6 Fig. 4 Severe tracheal luminal stenosis in a control dog after 6 months. Bronchoscopic views from the proximal anastomosis (left) and just proximal to the stenosis (right). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

7 Fig. 5 Luminal surfaces of two prostheses. At the top is shown a large area of mesh exposure in a prosthesis from a control dog after 12 months. The bottom photo shows a small area of mesh exposure (arrowheads) in a prosthesis from a dog in the omentopexy group after 12 months. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

8 Fig. 6 Regenerated mucosa with epithelial lining on the mesh of the prosthesis from a dog in the omentopexy group after 12 months. The mucosa is thicker than the normal tracheal mucosa. L, Tracheal lumen; M, mesh of the prosthesis; C, tracheal cartilage (hematoxylin and eosin staining; original magnification ×5). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

9 Fig. 7 Ciliated epithelium is present on the regenerated mucosa near the anastomosis (top), but only squamous epithelium is present in the middle of the prosthesis (bottom) in a dog in the omentopexy group after 12 months (hematoxylin and eosin staining; original magnification ×50). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

10 Fig. 7 Ciliated epithelium is present on the regenerated mucosa near the anastomosis (top), but only squamous epithelium is present in the middle of the prosthesis (bottom) in a dog in the omentopexy group after 12 months (hematoxylin and eosin staining; original magnification ×50). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

11 Fig. 8 Scanning electron microscopic views of the luminal surface. Dense cilia like those of normal tracheal epithelium are present on the prosthesis near the anastomosis (left) and a few ciliated epithelial cells are present in areas where only squamous cell lining was demonstrated by light microscopy (right). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

12 Fig. 8 Scanning electron microscopic views of the luminal surface. Dense cilia like those of normal tracheal epithelium are present on the prosthesis near the anastomosis (left) and a few ciliated epithelial cells are present in areas where only squamous cell lining was demonstrated by light microscopy (right). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

13 Fig. 9 Angiographic roentgenograms taken at the time the dogs were killed (3 months). Hardly any regenerated vessels are present in the prosthesis of a control dog (top), whereas there are a few vessels (arrows) in the prosthesis of a dog in the omentopexy group (bottom). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

14 Fig. 10 Roentgenogram of longitudinal sections of the prosthesis of a dog in the omentopexy group 6 months after reconstruction. Some new vessels (arrows) run vertically from the outside of the prosthesis to the subepithelial region. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (97) ) Copyright © 1997 Mosby, Inc. Terms and Conditions

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