Mucociliary transport following tracheal resection and end-to-end anastomosis was evaluated in beagle dogs, using the movement of 99MTC labeled sodium pertechnetate solution as a marker. Preoperatively, mucociliary clearance was stable, but a three-fold decrease in tracheal mucus movement was found three days postoperatively. Clearance rates had returned to normal by 31 days postoperatively and remained stable over a ten week period of observation. By histological examination, normal ciliated epithelium was seen within six months following resection and anastomosis. Since up to 25% (4 cm or seven tracheal rings) of tracheal length was removed, significant longitudinal loss can take place without functional impairment of mucociliary clearance. Circumferential narrowing, however, was associated with a significant decrease in clearance.
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References
1.
FergusonDJWildJJWangensteenOH: Experimental resection of the trachea. Surgery28: 597–619, 1950.
2.
GrilloHC: Reconstruction of the trachea. Thorax28: 667–679, 1973.
3.
NaefAP: Tracheobronchial reconstruction. Ann Thorac Surg15: 301–312, 1973.
LefemineAAMacDonnellKMoonHS: Tracheal stenosis following cuffed tube tracheostomy: Anatomical variation and selected treatment. Ann Thorac Surg15: 456–462, 1973.
8.
LongmireWP: The repair of large defects of the trachea. Ann Otol Rhinol Laryngol57: 875–883, 1948.
9.
BelseyR: Resection and reconstruction of the intrathoracic trachea. Br J Surg38: 200–205, 1950.
10.
ClagettOTMoerschHJGrindlayJH: Intrathoracic tracheal tumors: Development of surgical techniques for their removal. Ann Surg135: 520–530, 1952.
11.
BeallACHarringtonOBGreenbergSD: Tracheal reconstruction with heavy marlex mesh. Arch Surg86: 970–978, 1963.
12.
MiscallLMcKittrickJBGiordanoRP: Stenosis of trachea: Resection and end-to-end anastomosis. Arch Surg87: 726–731, 1963.
13.
CantrellJRFolseJR: The repair of circumferential defects of the trachea by direct anastomosis: Experimental evaluation. J Thorac Cardiovasc Surg42: 589–598, 1961.
14.
NachRLRothmanM: Injuries to the larynx and trachea. Surg Gynecol Obstet16: 614–622, 1943.
15.
GrilloHC: Obstructive lesions of the trachea. Ann Otol Rhinol Laryngol82: 770–777, 1973.
16.
MullikenJBGrilloHC: The limits of tracheal resection with primary anastomosis: Further anatomical studies in man. J Thorac Cardiovasc Surg55: 418–421, 1968.
GrilloHCDignanEFMiuraT: Extensive resection and reconstruction of mediastinal trachea without prosthesis or graft: An anatomical study in man. J Thorac Cardiovasc Surg48: 741–749, 1964.
19.
NaefAP: Extensive tracheal resection and tracheobronchial reconstruction. Ann Thorac Surg8: 391–400, 1969.
20.
OguraJHRoperCL: Surgical correction of traumatic stenosis of larynx and pharynx. Laryngoscope72: 468–480, 1962.
21.
DedoHHFishmanNH: Laryngeal release and sleeve resection for tracheal stenosis. Ann Otol Rhinol Laryngol78: 285–295, 1969.
22.
DedoHHFishmanNJ: The results of laryngeal release, tracheal mobilization and resection for tracheal stenosis in 19 patients. Laryngoscope83: 1204–1210, 1973.
23.
WardellJRChakrinLWPayneBJ: The canine tracheal pouch: A model for use in respiratory mucus research. Am Rev Respir Dis101: 741–754, 1970.
24.
GiordanoAMMorrowPE: Chronic low-level nitrogen dioxide exposure and mucociliary clearance. Arch Environ Health25: 443–449, 1972.
25.
MorrowPEGibbFRGaziogluK: The clearance of dust from the lower respiratory tract of man: An experimental study, in DaviesCN (ed): Inhaled Particles and Vapours II. New York: Pergamon Press, 1966, pp 351–359.
26.
MarinMGMorrowPE: Effect of changing inspired 02 and CO2 levels on tracheal mucociliary transport rate. J Appl Physiol27: 385–388, 1969.
27.
AsmundssonTKilburnKH: Mucociliary clearance rates at various levels in dogs lungs. Am Rev Respir Dis102: 388–397, 1970.
28.
SakakuraYProcterDF: The effects of various conditions on tracheal mucociliary transport in dogs. Proc Soc Exp Biol Med140: 870–879, 1972.
29.
WannerAHirschJAGreeneltchDE: Tracheal mucous velocity in beagles after chronic exposure to cigarette smoke. Arch Environ Health27: 370–371, 1973.
30.
HildingAC: Ciliary streaming in the bronchial tree and the time element in carcinogenesis. N Engl J Med256: 634–640, 1957.
31.
MorinariHShimadaKTaplinGV: Bronchial mucus after lung autotransplantation in dogs. J Thorac Cardiovasc Surg67: 484–490, 1974.
32.
EdmundsLHStalloneRJGrafPD: Mucus transport in transplanted lungs of dogs. Surgery66: 15–22, 1969.
33.
BrodyJSKlempfnerGStaumMM: Mucociliary clearance after lung denervation and bronchial transection. J Appl Physiol32: 160–164, 1972.
34.
MaiselBDingwallJA: Primary suture of the divided cervical trachea: A preliminary experimental study. Surgery27: 726–729, 1950.
35.
RyanderR: Current techniques to measure alterations in the ciliary activity of intact respiratory epithelium. Am Rev Respir Dis93: 67–72, 1966.
36.
HillL: The ciliary movement of the trachea studied in vitro.Lancet215: 802–805, 1928.
37.
CouraudLMassardJFBruneteauA: Notre experience des resections anastomoses de la trachee et des bronches souches. Poumon Coeur28: 185–188, 1972.
38.
CarcassonneMDorVAubertJ: Tracheal resection with primary anastomosis in children. J Pediatr Surg8: 1–8, 1973.
