Experimental use of new absorbable tracheal stent

J Pediatr Surg. 2018 Jul;53(7):1305-1309. doi: 10.1016/j.jpedsurg.2017.11.038. Epub 2017 Nov 16.

Abstract

Background/purpose: Silicone and metallic stents are not effective in children with tracheobronchial stenosis or tracheomalacia. Herein, we aimed to evaluate the clinical manifestations and histological reaction of rabbit trachea to the presence of a new poly(lactic-co-glycolic acid) with polyisoprene (PLGA/PI) polymer absorbable stent.

Methods: Fourteen adult white rabbits (weight, 3.0-3.5kg) were randomly assigned to three groups: Group I (n=6): PLGA/PI spiral stent; Group II (n=6): PLGA/PI fragment; and Group III (n=2): controls. After a longitudinal incision on three cervical tracheal rings, the stents and fragments were inserted into the trachea and fixed onto the lateral wall with nonabsorbable sutures.

Results: The stented group showed significantly more stridor at rest (p=0.0041), agitation (p=0.014), and use of accessory muscles (p=0.0002) and required more emergency endoscopies than the fragment group. Further, it showed significantly more remarkable histological inflammatory damage than the fragment and control groups (p=0.002).

Conclusions: The new PLGA/PI polymeric stent implanted into the trachea of rabbits caused more clinical manifestations and histologically verified inflammatory reaction than the PLGA/PI polymeric fragment. Future studies should be aimed at reducing the stent-wall thickness.

Keywords: Absorbable tracheal stent; Bronchoscopy; Experimental tracheal surgery.

MeSH terms

  • Absorbable Implants* / adverse effects
  • Animals
  • Endoscopy
  • Male
  • Polyesters
  • Polymers
  • Postoperative Complications / etiology
  • Prosthesis Design
  • Rabbits
  • Random Allocation
  • Respiratory Sounds / etiology
  • Stents* / adverse effects
  • Trachea / pathology
  • Trachea / surgery*
  • Tracheal Stenosis / surgery

Substances

  • Polyesters
  • Polymers
  • poly(lactide)