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Comparison of bioabsorbable materials for use in artificial tracheal grafts

^a Department of Surgery, Division of Chest Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae, Kawasaki 2168511, Japan
^b St. Marianna University Graduate School of Medicine, Institute of Advanced Medical Science, 2-16-1 Sugao Miyamae, Kawasaki 2168511, Japan
^c Gunze Ltd, Research and Development Center, One Ishiburo Inokura-shin-machi Ayabe, Kyoto 6238512, Japan
^d Department of Plastic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae, Kawasaki 2168511, Japan
^e Department of Indoor Environmental Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 6348521, Japan

*Corresponding author. Chest Disease Center, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Deaconess Suite 207, Boston, MA 02215, USA. Tel.: +1-617-632-9976; fax: +1-617-632-8253.

E-mail address: htsukada{at}bidmc.harvard.edu (H. Tsukada).

Limited information exists regarding the usefulness of bioabsorbable materials in the design of tracheal grafts. The aim of this study was to evaluate the feasibility of three bioabsorbable materials for use as artificial trachea. Three sets of grafts were prepared: Group 1 (n=6), knitted polyglactin 910 mesh; Group 2 (n=3), copolymer of L-lactide and -caprolactone sponge reinforced with polyglycoride fibers; and Group 3 (n=8), copolymer of L-lactide and -caprolactone sponge covered with knitted poly-L-lactide mesh. All grafts were internally reinforced with a titanium stent. A 10-cartilage-ring-length of canine mediastinal trachea was resected and replaced by a bioabsorbable prosthesis with the aid of an omental flap. In Groups 1 and 2, the patency rates decreased below 50% within two months after surgery. In Group 3, six of eight dogs maintained patency rates above 50% from 10 months to 2 years after surgery. Grafts prepared with a copolymer of L-lactide and -caprolactone sponge covered with knitted poly-L-lactide mesh (Group 3) can function for up to two years after surgery. These results provide evidence toward the feasibility of utilizing bioabsorbable materials as a tracheal prosthesis.

Key Words: Trachea; Tracheal surgery; Prosthesis; Experimental surgery; Bronchoscopy