Repair of non-circumferential cervical trachea defects by three different latissimus dorsi flaps. A comparative studyin an experimental setting.

Détails

ID Serval
serval:BIB_21F0BB2C6B36
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Repair of non-circumferential cervical trachea defects by three different latissimus dorsi flaps. A comparative studyin an experimental setting.
Périodique
European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Auteur(s)
Christoforidis D., Pezzetta E., Simon-Valla S., Lang F., Gebhardt S., Pasche P., Ris H.B.
ISSN
0014-312X (Print)
ISSN-L
0014-312X
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
37
Numéro
3
Pages
129-136
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
BACKGROUND: Large intrathoracic airway defects may be closed using a pedicled latissimus dorsi (LD) flap, with rewarding results. This study addresses the question of whether this holds true for extrathoracic non-circumferential tracheal defects.
METHODS: A cervical segment of the trachea of 4 x 1 cm was resected in 9 white male pigs. The defect was stented with a silicone stent for 3 months and closed either by an LD flap alone (group a, n = 3), an LD flap with an attached rib segment covered by pleura (group b, n = 3), or an LD flap reinforced by a perforated polylactide (MacroPore) plate (group c, n = 3). The trachea was assessed by rigid endoscopy at 3 and 4 months and histologically at 4 months postoperatively.
RESULTS: The degree of stenosis at the level of the reconstruction at 4 months was 25, 50 and 75% in group a, 15, 50 and 60% in group b, and 20, 95 and 95% in group c, respectively. The percentage of the defect covered by columnar epithelium was 100% in all animals of group a, 60, 100 and 100% in group b, and 10, 0 and 0% in group c. Resorption of the rib was seen in all animals of group b and obstructive inflammatory polyps were found in 2 animals of group c.
CONCLUSION: Pedicled LD flaps provided less satisfactory results for closure of large non-circumferential extrathoracic airway defects than observed after intrathoracic reconstruction. A pedicled rib segment added to the LD flap did not improve the results obtained from LD flap repair alone, and an embedded MacroPore prosthesis may result in severe airway stenosis due to plate migration and intense inflammatory reaction protruding into the tracheal lumen.
Mots-clé
Animals, Constriction, Pathologic/etiology, Constriction, Pathologic/pathology, Endoscopy, Epithelium/pathology, Inflammation/pathology, Male, Muscle, Skeletal/transplantation, Neck, Polyesters/adverse effects, Polyps/etiology, Polyps/pathology, Postoperative Period, Prostheses and Implants/adverse effects, Reconstructive Surgical Procedures/adverse effects, Surgical Flaps, Swine, Time Factors, Trachea/pathology, Trachea/surgery, Tracheal Diseases/etiology, Tracheal Diseases/pathology
Pubmed
Web of science
Création de la notice
29/01/2008 13:00
Dernière modification de la notice
31/08/2019 13:48
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