Clinical Experience of Zhao's Artificial Trachea

The practice of artificial tracheal prosthesis has been a major challenge to the entire surgical field worldwide until now. The previously applied prosthesis is " inner stent " type, which is unable to heal biologically with native trachea. The newly developed design, the Zhao's artificial trachea, uses a memory alloy mesh combined with traditional operation procedures. Following a 2‑year experimental period, the device has been applied to seven patients with satisfying results. We believe this to be a successful artificial trachea that is capable of complete biologically healing with the native trachea. No rejection, infection, or major complications were present in the seven patients, and the Zhao's artificial trachea may be considered a real part of the trachea. Seven consecutive cases of tracheal resection and reconstruction with Zhao's artificial trachea (6 male and 1 female; 3 with malignant and 4 with benign diseases; aged 14–48 years) were completed between the year 2002 and 2004. All the patients were informed of the procedure and completed consent forms. In all instances, the patients exhibited normal physical examination and laboratory tests except for tracheal obstruction. The four patients with benign diseases continue to live a normal life. The three malignant patients have all subsequently died; however, the artificial trachea showed good functionality prior to death. During the operation, great care was taken to avoid damaging blood supply in the muscle pedicle. The artificial trachea was anastomosed without tension, kink, or rotation. For the first patient, a tracheotomy was made to prevent edema of the artificial trachea below the lower anastomosis. In the remaining 6 cases, the procedures were performed without preventive tracheotomy. The length of the resected trachea was 5.0–8.0 cm and the length of the artificial trachea was 2.5–4.5 cm. However, the anastomosis was tension‑free without difficulties, resulting in no need for the chin to sternum suturing and corresponding neck over‑flexion. Therefore, the postoperative quality of life for the patients was relatively good. A 48‑year‑old female patient suffered from tracheal carcinoid tumor for 6 years and received laser treatment many times. However, recurrence occurred with increased shortness of breath. The tumor located in the upper airway, started 2 cm below the vocal cord, obstructed over 80% tracheal lumen, invaded more than 4/5 circle of the tracheal wall, expended downward along the tracheal wall for more than 4.5 cm, and pressed to nearby structure [Figure 1a]. The patient was unable to lie down …