记忆合金网二期成形人工气管置换术

Replacement of artificial tracheal prosthesis by two-stage procedure with memory-alloy mesh

目的 探讨能与自体气管完全愈合为一体的人工气管的制备方法。 方法 应用记忆合金网二期手术成形制成人工气管 ,经过 2年的动物实验后 ,应用于临床 ,为 1例复发性气管类癌 ,重建了气管。 结果 这种外带有肌肉血管蒂 ,内面为皮肤复盖替代了气管上皮的“三明治式”人工气管 ,上下端吻合口与自体气管完全愈合 ,结合为一体 ,完全符合气管的生理机能。手术 1次成功 ,无并发症 ,术后随访 6个月 ,患者生活劳动正常。 结论 “三明治式”记忆合金网二期手术成形带蒂人工气管能与自体气管紧密愈合并完全融为一体。这种气管内面复盖自体皮肤 ,没有排异、血供丰富、易于存活。

Objective To design an artificial trachea which can totally heal with the native trachea. Methods Using memory-alloy mesh as the skeleton to construct an artificial trachea by two-stage operation. After 2-year animal experiment we successfully performed the operation in a patient with recurrent carcinoid of the trachea, radically resected the tumor and primarily reconstructed the trachea. Results The inner side of this 'sandwich' artificial tracheal prosthesis was coated with skin and outside the memory-alloy mesh was muscle and vessel pedicle with good blood supply. The upper and lower anastomosis completely healed with recipient′s trachea with a full recovery of trachea. Six-month follow-up showed that the patients resumed their normal life. Conclusion The artificial trachea completely healed with the native trachea and became a part of the human trachea. The inner side of artificial trachea is coated with intact native skin tissue with ample blood supply, totally alive without rejection. Therefore, the pedicled artificial tracheal prosthesis is an real artificial trachea.