Advances in tracheal reconstruction.
Advances in tracheal reconstruction.
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DOI：
10.1097/gox.0000000000000097
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Hofer SO
中科院分区：
文献类型：
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作者：
Haykal S;Salna M;Waddell TK;Hofer SO
长段气管缺损的重建是头颈部和胸部重建手术中最有趣和最复杂的问题之一，近年来全球对长段气管缺损重建的兴趣有所恢复。气管作为空气的管道，其亚单位包括上皮层、透明软骨和节段性血液供应，使其重建尤其具有挑战性。人们描述了无数种替换气管的尝试。这些以及解剖，适应症和方法，包括显微外科气管重建将进行审查。新技术，如组织工程方法也将讨论。用合成支架代替气管的多次尝试都以失败告终。从这些失败中吸取的主要教训是，气管绝不能被视为一根“简单的管子”。了解解剖学、发育生物学、生理学和影响气管的疾病是解决这个问题的必要条件。
A recent revival of global interest for reconstruction of long-segment tracheal defects, which represents one of the most interesting and complex problems in head and neck and thoracic reconstructive surgery, has been witnessed. The trachea functions as a conduit for air, and its subunits including the epithelial layer, hyaline cartilage, and segmental blood supply make it particularly challenging to reconstruct. A myriad of attempts at replacing the trachea have been described. These along with the anatomy, indications, and approaches including microsurgical tracheal reconstruction will be reviewed. Novel techniques such as tissue-engineering approaches will also be discussed. Multiple attempts at replacing the trachea with synthetic scaffolds have been met with failure. The main lesson learned from such failures is that the trachea must not be treated as a “simple tube.” Understanding the anatomy, developmental biology, physiology, and diseases affecting the trachea are required for solving this problem.