Segmental tracheal reconstruction by 3D-printed scaffold: Pivotal role of asymmetrically porous membrane.

OBJECTIVES/HYPOTHESIS Three-dimensional (3D) printed scaffold for tracheal reconstruction can substitute the conventional treatment of tracheal stenosis. This study investigated the survival outcomes of segmental tracheal reconstruction using 3D printed polycaprolactone (PCL) scaffold with or without asymmetrically porous membrane in rabbit animal model. STUDY DESIGN Animal study. METHODS Six mature New Zealand white rabbits were categorized into two groups (three animals for each) according to the procedures they received: tracheal reconstruction using 3D printed PCL scaffold without asymmetrically porous membrane (group 1) versus with asymmetrically porous membrane (group 2). We compared the endoscopic findings of tracheal lumen, radiologic assessment using microcomputed tomography (CT) scanner and histologic findings. Overall survival duration after procedure was compared in both groups. RESULTS The survival of group 2 was longer than group 1 (21, 37, 46 days vs. 4, 10, 12 days, respectively). Although mucosal regeneration in tracheal lumen was not full enough in both groups, the patency was well maintained in group 2. Micro-CT and histologic analysis showed that there were tracheal narrowing in the whole length in group 1, whereas only the anastomosis site was stenotic in group 2. CONCLUSION Asymmetrically porous membrane reinforced by 3D printed mesh is promising as a 360-degree tracheal substitute with comparable survival and luminal patency. Further study is necessary to minimize the narrowing of the anastomosis site and improve the mucosal regeneration for longer survival. LEVEL OF EVIDENCE NA. Laryngoscope, 126:E304-E309, 2016.