Document Detail

Bronchial replacement with arterial allografts.
MedLine Citation:
PMID:  20609787     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pneumonectomy is well known for a high risk of postoperative death. The alternative, sleeve lobectomy, is sometimes technically inaccessible, and is associated with locoregional recurrence. In certain situations, the use of a bronchial substitute would allow longer bronchial resections with better security margins. Previous experiments demonstrated that aortic grafts are valuable tracheal and carinal substitutes. The present study evaluated bronchial replacement with arterial allografts. METHODS: Fifteen female sheep underwent a left bilobectomy with replacement of the bronchus intermedius with arterial allografts: 5 received a fresh graft (group 1) and 10 received cryopreserved (group 2). A bronchial silicone stent was used to confer rigidity. Evaluation was conducted on clinical and histologic criteria at regular intervals up to 18 months. RESULTS: There were no perioperative deaths. Atelectasis, the only early postoperative complication (n = 2), was successfully treated by fiberscopic aspiration. The late postoperative period was uneventful in 12 sheep. Complications included 1 bronchopneumonia, 1 pulmonary abscess, and 1 distortion of the bronchial stent. Fiberscopic examination revealed 3 sheep with granuloma formation. The bronchial stent was removed in 3 sheep, 1 at 9 months and 2 at 12 months, without clinical complications or stenosis of the graft. Histologic analysis showed regeneration of new bronchial tissue, comprising epithelium and cartilage. CONCLUSIONS: This study confirmed that an arterial allograft could be a valuable bronchial substitute. The use of a bronchial substitute offers new perspectives in surgical resection of lung cancer because it would avoid pneumonectomy in some patients.
Dana M Radu; Agathe Seguin; Patrick Bruneval; Anne Fialaire Legendre; Alain Carpentier; Emmanuel Martinod
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  252-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Département de Chirurgie Thoracique et Vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Université Paris XIII, Faculté de Medecine SMBH, Bobigny, France.
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MeSH Terms
Arteries / transplantation*
Bronchi / surgery*
Feasibility Studies
Models, Animal
Pneumonectomy / adverse effects
Transplantation, Homologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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