Remplacement de trachée par reconstructions chirurgicales : état actuel de la recherche

Objective

To review the main studies and the recent surgical procedures in tracheal reconstruction.

Material and method

The literature search was conducted using the key words “tracheal reconstruction”, “grafts”, and “tissue engineering” and by selecting references from the articles reviewed as well as the experience of the authors in this field.

Results

Surgical reconstruction for tracheal replacement without using biomaterials involves tissue grafts (auto- or allografts) and tissue engineering. Among the many procedures already described, three new techniques have emerged these past few years employing autologous mesenchymal stem-cell-derived chondrocytes, autologous cultured epithelial cells, and a matrix derived from tracheal graft; costal cartilage, recipient mucosa, and local or free flaps, and an aortic graft. These procedures have been proposed in humans with apparently good results but with a still limited follow-up.

Conclusions

Tracheal reconstruction techniques have recently progressed and replacing a long segment of trachea can be envisaged for the future. Moreover, these reconstructions, in conjunction with biomaterial development, would facilitate the design and the implantation of a laryngeal prosthesis.