Tracheal reconstruction with porous high-density polyethylene tracheal prosthesis

The variety of methods used for the treatment of severe tracheal stenosis a nd the occasional failure to obtain lasting and consistent relief are measu res of the difficulty of the problem. Presently, several surgical approache s are used for reconstructing large defects of the cervical trachea, remind ing us that no single technique has gained wide clinical acceptance. We res ected a U-shaped cartilage from 6 to 8 rings of the trachea of 10 New Zeala nd rabbits. We used a porous high-density polyethylene (PHDP) prosthesis to reconstruct the cervical trachea, and did not perform a tracheotomy during this operation. We followed up the rabbits for 4 to 10 months. One of the rabbits died in the second month because of respiratory distress; another w as lost in the fourth month of the study while delivering young. The others continued to thrive; in fact, one of them gave birth 3 times after our stu dy and wits well able to take care of her young. At the end of the study, t he rabbits were painlessly sacrificed in order to remove the larynx and tra chea and examine them histopathologically. In the histopathologic examinati ons, the prostheses were incorporated into the native trachea and adhered t o the surrounding organs, especially to the esophagus. No mucosal irregular ities were seen on the surface of the prosthesis, and all the surfaces appe ared to be covered with ciliated pseudostratified epithelium. This tracheal prosthesis provides good results in rabbit tracheal reconstruction, and ap pears very promising for the clinical repair of tracheal defects.