INTRATHORACIC TRACHEAL RECONSTRUCTION WITH A COLLAGEN-CONJUGATED PROSTHESIS - EVALUATION OF THE EFFICACY OF OMENTAL WRAPPING

Reconstructions of the intrathoracic trachea in 24 dogs were done with the use of 50 mm long collagen-conjugated tracheal prostheses. Omenta l wrapping was also done in 14 of the dogs (omentopexy group) to evalu ate the efficacy of this option in comparison with results in the othe r 10 dogs (control group). All 24 dogs had uneventful postoperative co urses and were killed at 4 weeks or 3, 6, or 12 months after the opera tion. Better epithelialization and fewer complications, such as mesh e xposure and luminal stenosis, were observed in the omentopexy group th an in the control group. Angiography and analysis of regenerated blood vessels revealed that vessel ingrowth had started within 4 weeks and that vessel formation reached its maximal point within 6 to 12 months in the omentopexy group. In contrast, revascularization of the subepit helial region in the control group was poor even after 3 months, and v essel formation continued for as long as 12 months. The differences be tween the two groups were considered to be mainly a result of the spee d of blood vessel ingrowth into the regenerated mucosa. We conclude th at our prosthesis can be used safely for intrathoracic tracheal recons truction and that omental wrapping is a useful supplementary method th at reduces the occurrence of complications.