Study on Tracheal Prosthesis using promotive materials for tissue regeneration

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(1) We replaced the intrathoracic trachea of dogs'using our tracheal prosthesis. The tracheal prosthesis consists of Marlex mesh (polypropylene mesh) reinforced with a continuous polypropylene spiral, which is grafted and coated with porcine dermal collagen. At the operation the air leakage from the tracheal prosthesis and anastomotic site were minimal. All the prosthesis were completely incorporated with the host tissue. However, the exposure of mesh to tracheal lumen were more remarkably observed than in the previous experiment of replacement at the cervical trachea.(2) In order to overcome this problem, we added omentpexy to the intrathoracic tracheal replacement prosedure. As the result, the regeneration of neomucosa was faster and more complete than in the previous replacements without omentopexy. Moreover, in histological study, the epithelial regeneration were faster and more complete. But, since there were still remain in some dogs, stenoses of tracheal lumen furter improvement is requiered to promote the epithelial regeneration.(3) Therefore, we manufactured a new tracheal prosthesis to promote the regeneration of neomucosa. This prosthesis consists of tthe same as the prosthesis used in the experiment (1) as a bulk on which collagen sponge made from porcine dermal collagen was laminated.We replaced dog's cervical tracheae using this prosthesis. This new trachea could partially overcome the 2 major problems such as stenosis of the lumen and exposure of the mesh. However, since collagen sponge easily came off from the cylinder of mesh, the complications at the anastomotic sites is consider to be ready to occure. As the air leakage from this trachea were lethal in some intrathoracic replacements, the use of collagen sponge appeared not so effective than expected.