Application of homologous grafting and primary suture in the reconstruction of trachea (Experimental study)

Tracheal resection and recontruction is a procedure perfomed in the management of a variety of tracheal pathologies. However, there is not a satisfactory result in the tracheal resection and reconstruction despite many researches and studies. The different methods of the segmental reconstruction of the trachea include; primary end-to-end anastomosis, reconstruction using homologous grafting, reconstruction using autogenous tissue grafting, reconstruction using prosthetic graft materials.This study was designed to evaluate the results of end-to-end anastomosis and homologous grafting.In the current study, 10 New Zealand rabbits were used. Three segmental cartilages of each rabbit were excised. Then the rabbits were divided into two groups: Group I (n=5, end-to-end anastomosis), Group II (n=5, segmental grafting from the first group).Following the sacrification on the 20th day postoperatively, the situation of the level of the anastomosis, the retention of the secretion in the lumen, the inflammation and the adhesions around the surrounding tissue were evaluated. Thereafter, the measurements from different levels of anastomosis were compared between the groups, and the materials were analysed histopathologically.In conclusion, it was found that although both techniques cause a statistically significant narrowing of the lumen in the lateral, anterposterior and cross-sectional areas; the degree of the narrowness will not cause a stenosis when compared with the general stenotic indexes. It was also detected that a better airway opening is possible when an end-to-end anastomosis is performed. Meanwhile, homologous grafts are considered to be one of the promising solutions in the tracheal resection and reconstruction.Keywords: Trachea, primary end-to-end anastomosis, homologous grafting