Prototype of the prosthesis for restoration of the trachea integrity after its resection
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BOHANOV, Gheorghii. Prototype of the prosthesis for restoration of the trachea integrity after its resection. In: MedEspera: International Medical Congress for Students and Young Doctors, Ed. 7th edition, 3-5 mai 2018, Chişinău. Chisinau, Republic of Moldova: 2018, 7, pp. 106-107.
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MedEspera
7, 2018
Congresul "International Medical Congress for Students and Young Doctors"
7th edition, Chişinău, Moldova, 3-5 mai 2018

Prototype of the prosthesis for restoration of the trachea integrity after its resection


Pag. 106-107

Bohanov Gheorghii
 
National Pirogov Memorial Medical University, Vinnytsya
 
 
Disponibil în IBN: 4 noiembrie 2020


Rezumat

Introduction. An optimal way to restore the integrity of the trachea after its resection is an "end to end" anastomosis. But, with the removal of large fragments of the trachea, and especially restenosis correction, there are difficulties that can be eliminated by prosthetics. However, the issue of material selection for tracheal prosthesis remains unresolved and relevant. Aim of the study. To develop a model of alloprosthesis of the fragment of a trachea and to test it on a living organism; during the intraoperative adaptation to identify possible structural deficiencies and correct them. Materials and methods. Linear vascular prosthesis 10 mm in diameter, tracheobronchial stent "Ultraflex", suture material, a set of surgical instruments, preparations for intravenous anesthesia, dressing material. Accounting documents and statistical indicators of the activities of the Department of Thoracic Surgery Vinnytsia Regional Clinical Hospital named by M.I. Pyrogov for 2004-2018. Applied methods of scientific subject modeling, analytical and comparative analysis. An in vivo prosthesis trial was performed on a not thoroughbred rabbit weighing 4100 grams. The intervention consisted of sewing the prosthesis in the trachea of the animal after its intersection with the imposition of two "end-to-end" anastomosis. Results. In the period between 2004 – 2018 seven circular trachea resections (4 - cervical and 3 - mediastinal divisions) were carried out, all - concerning posttraheostomy stenoses. The length of the resected segment was from 2 to 5 rings. The connection of the ends at the removal of 4 or more rings caused some technical difficulties, although the observation ended with the recovery of patients. The expediency of replacing the fragment of the trachea in such cases led to an attempt to develop a prosthetic of its own design. Testing this model of a denture in a living organism has highlighted some of its structural deficiencies, which influenced the course of intervention and the early postoperative period. In particular, during the intervention there was a problem of adaptation of the ends of the prosthesis to the ends of the trachea. And after the operation there was a partial occlusion of the prosthetic lumen due to adhesion of the blood clots to its internal surface. Taking into account the experience gained, we have made changes in the design of the implant. The new model of tracheal dentures seems rather promising for use. Conclusions. The prototype of the prosthesis manufactured by us meets most of the modern requirements and our goals. In the future, the use of the implant of the proposed type can simplify the course of the resection of large tracheal fragments and contribute to avoiding a number of perioperative complications.

Cuvinte-cheie
trachea, prosthesis, integrity restoration, resection