Tissue-engineered trachea for airway reconstruction.
Tissue-engineered trachea for airway reconstruction.
复制标题
DOI：
10.1002/lary.20700
复制
发表时间：
2009-11
期刊：
影响因子：
--
通讯作者：
Dennis JE
中科院分区：
文献类型：
--
作者：
Weidenbecher M;Tucker HM;Gilpin DA;Dennis JE
无支架软骨已被用于设计生物相容性和稳定性的新气管，当植入腹部时，产生具有良好机械稳定性的血管化新气管。本动物研究的目的是确定新气管植入颈部是否可以成功用于节段气管重建。用新西兰大白兔耳廓软骨细胞构建无支架软骨。工程软骨和带状肌肉瓣被包裹在硅胶管上，并在气管旁植入。植入后12周和14周采用新气管重建20mm气管缺损。在6只兔中，2只兔将新气管及其腔内带状肌瓣放入缺损处，然后进行端到端吻合；2只动物的部分肌瓣术后立即进行气管重建；在剩下的2只动物中肌肉瓣被部分移除，硅胶被重新插入，结构暂时被重新植入，以便在暴露的软骨上形成纤维衬里，然后在6周后进行气管重建。所有植入的新气管结构血管化良好，机械性能良好。气管重建后，没有动物立即出现呼吸窘迫的迹象，但有2只兔在24小时后因气管内肌瓣广泛水肿而死亡。其余4只兔出现新气管纤维性狭窄，12 ~ 39 d死亡。组织工程新气管被证明具有足够的稳定性，但缺乏足够的气管内膜，导致气管狭窄。
Scaffold-free cartilage has been used to engineer a biocompatible and stable neotrachea that, when implanted into the abdomen, produces a vascularized neotrachea with excellent mechanical stability. The purpose of this animal study was to determine if neotracheal constructs implanted in the neck, could successfully be used for segmental tracheal reconstruction. Animal study Auricular chondrocytes from New Zealand White rabbits were used to engineer scaffold-free cartilage. Engineered cartilage and a strap muscle flap were wrapped around a silicone tube and implanted paratracheally. Twelve and 14 weeks post-implantation neotracheas were used to reconstruct a 20mm tracheal defect. In 2 of the 6 rabbits, the neotrachea with its intraluminal situated strap muscle flap was dropped into the defect followed by an end-to-end anastomosis; in 2 animals the muscle flap was partially followed immediately by tracheal reconstruction; and in the remaining 2 animals the muscle flap was partially removed, the silicone re-inserted and the construct temporarily re-implanted to allow formation of a fibrous lining over the exposed cartilage followed by tracheal reconstruction 6 weeks later. All implanted neotracheal constructs were well vascularized and mechanically sound. Following tracheal reconstruction, none of the animals showed immediate signs of respiratory distress, however, 2 rabbits died after 24 hours due to extensive endotracheal muscle flap edema. The remaining 4 rabbits developed fibrous stenosis of the neotrachea and died after 12 to 39 days. Tissue engineered neotracheas proved to have adequate stability, but lacked adequate endotracheal lining which lead to neotracheal stenosis.