关于气管替代物研究的进展与展望

Progress and prospect of studies on tracheal substitute

目前,广泛切除后气管重建仍然是胸外科领域的一大挑战。对于长度>6 cm的气管缺损,常需要气管替代物移植进行重建。气管替代物包括人工合成假体、自体组织气管、同种异体移植、异种移植和组织工程气管。理想的气管替代物尚不清楚,但一些技术已在动物或临床应用中显示出较好效果。本文回顾了过去几十年间气管替代物在应用中的成果与不足。其中,自体组织气管和同种异体主动脉移植展现出良好的应用前景。对于干细胞、组织工程气管的研究近年来引起人们的极大兴趣,但目前这种方法的长期结果欠佳,尚需要进一步的研究与优化。

To date,tracheal reconstruction after extensive resection remains a major challenge in the field of thoracic surgery.Tracheal replacement with a substitute is needed for reconstruction when the length of tracheal defect is more than 6 cm.Tracheal substitutes include synthetic prosthesis,autologous tissue composite,allograft,xenograft,and tissue-engineered trachea.At present,the ideal trachea substitute is still unclear,but some substitutes have shown good results in animal or clinical applications.This article reviews the achievements and limitations of each tracheal substitute over the past decades.Autologous tissue composite and alloaortic transplantation have shown promises in clinical application.The research on stem cells and tissue-engineered trachea has aroused great interest in recent years,but the poor long-term results of this approach right now highlight that there is still a long way to go in this research field.