Tracheal reconstruction by esophageal submuscular tunneling: An experimental study

Hodjati, Hossein, Kazemi, Kourosh, Jalaeian, Hamed, Sharifiad, Hamid Reza, Roshan, Nagmeh and Tanideh, Nader (2008) Tracheal reconstruction by esophageal submuscular tunneling: An experimental study. Journal of Surgical Research, 150 1: 74-77. doi:10.1016/j.jss.2007.12.778

Author Hodjati, Hossein
Kazemi, Kourosh
Jalaeian, Hamed
Sharifiad, Hamid Reza
Roshan, Nagmeh
Tanideh, Nader
Title Tracheal reconstruction by esophageal submuscular tunneling: An experimental study
Journal name Journal of Surgical Research   Check publisher's open access policy
ISSN 0022-4804
Publication date 2008-11
Sub-type Article (original research)
DOI 10.1016/j.jss.2007.12.778
Volume 150
Issue 1
Start page 74
End page 77
Total pages 4
Place of publication Maryland Heights, MO, United States
Publisher Academic Press
Language eng
Formatted abstract
Background: The problem of how to treat large tracheal lesions remains a challenge in surgery. To reconstruct a long tracheal defect, a safe method other than end-to-end anastomosis is necessary.

Materials and methods: In 14 adult cross-breed dogs, a segment of trachea including seven tracheal rings was dissected and resected circumferentially. A submuscular tunnel was induced between mucosal and muscular layers of the adjacent esophagus lying right next to the trachea. An endotracheal tube was inserted
between the tracheal rings 2 and 3. Then it was passed cautiously through the esophageal submuscular tunnel and through the distal tracheal segment. The proximal and distal ends of the esophageal tunnel and trachea were approximated and anastamosed. The animals were extubated 10 days after the operation.

All dogs tolerated the surgical procedure well. The first two dogs experienced postoperative fever, tracheoesophageal fistula, aspiration pneumonia, and sepsis so hard bony components were omitted from diet. All survived animals were eating and barking well. The submuscular esophageal tunnel was patent in all animals. The new lumen was supported externally with fibrous connective tissue. The tunnelized area was covered completely with pseudostratified diliated epithelium.

Conclusion: Due to formation of fibrous tissue between skeletal muscular structures  of the neck and the external layer of the tunnelized esophagus, the new airway remained patent. Overall, air tightness, good reepithelialization, and relatively no limitation of esophageal length are the advantages of tracheal reconstruction by submuscular esophageal tunneling. This new method is worthy of further investigation, as it is technically feasible and easy to implement. 
Keyword Tracheal reconstruction
Experimental surgery
Esophageal tunneling
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Thu, 03 Sep 2009, 09:22:41 EST by Mr Andrew Martlew on behalf of School of Medicine