A tissue-engineering approach for stenosis of the trachea and/or cricoid.

Shin-ichi Kanemaru, Shigeru Hirano, Hiroo Umeda, Masaru Yamashita, Atsushi Suehiro, Tatsuo Nakamura, Toshiki Maetani, Koichi Omori, Juichi Ito
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引用次数: 20

Abstract

Conclusion: This new regenerative therapy shows great potential for the treatment of stenosis of the trachea and/or cricoids (STC).

Objectives: To estimate the potential of tissue-engineered artificial trachea (AT) for treatment of STC in clinical applications. We previously reported that AT was a useful material for implantation into a tracheal defect after resection of cancer. There are many causes of stenosis of the respiratory tract and STC is particularly difficult to treat.

Methods: The AT was a spiral stent composed of Marlex mesh made of polypropylene and covered with collagen sponge made from porcine skin. Three patients with STC were treated by this tissue-engineering method. All of them suffered from STC caused by long endotracheal intubations. They underwent a two-stage operation. In the first operation, after resection of the stenotic regions, the edge of the tracheal cartilage was sutured to the edge of the skin. The tracheal lumen was exposed and a T-shaped cannula was inserted into the large tracheostoma. At 3 weeks to 2 months after the first operation, the trachea and skin were separated. The trimmed AT with venous blood and basic fibroblast growth factor (b-FGF) was then implanted into the cartilage defect.

Results: Postoperatively, all patients were able to breathe easily and had no discomfort in their daily activities. Six months after the second operation, we observed enough air space in the trachea and cricoid by computed tomography (CT) imaging and fiber endoscopy.

气管和/或环状软骨狭窄的组织工程方法。
结论:这种新的再生疗法在治疗气管和/或环状索狭窄(STC)方面具有很大的潜力。目的:评价组织工程人工气管(AT)治疗STC的临床应用潜力。我们以前报道过AT是一种有用的材料,用于肿瘤切除后气管缺损的植入。引起呼吸道狭窄的原因很多,STC尤其难以治疗。方法:采用聚丙烯制成的Marlex网片和覆盖猪皮胶原蛋白海绵制成的螺旋支架。采用组织工程方法治疗3例STC患者。均为长时间气管插管所致STC。他们接受了两个阶段的手术。在第一次手术中,切除狭窄区域后,气管软骨边缘与皮肤边缘缝合。暴露气管腔,将t型套管插入大气管造口。第一次手术后3周~ 2个月,气管与皮肤分离。将经静脉血和碱性成纤维细胞生长因子(b-FGF)修饰的AT植入软骨缺损。结果:术后所有患者呼吸顺畅,日常活动无不适。第二次手术6个月后,我们通过计算机断层扫描(CT)和纤维内窥镜观察到气管和环状软骨有足够的空间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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