Advances in tracheal reconstruction and tissue engineering

Abstract

Tracheal stenosis represents a significant challenge. Surgeons continue to search for appropriate reconstructive techniques and grafting materials for long tracheal segment reconstruction. Grafts can be classified as synthetic, allogenic, autogenic, transplant, and engineered. Although none of these grafts have provided overwhelming success, acellular composite engineered grafts have shown early promise and can be applied in benign and malignant tracheal diseases. Intraluminal granulation tissue causing re-stenosis is the biggest challenge in tracheal reconstruction. Tracheal wound healing and tissue regeneration pathways must be deeply explored and better characterized to advance the field of tracheal reconstruction.

Keywords

Tracheal reconstruction / tracheoplasty / tissue engineering

References

[1] Gelbard A,Sandulache VC,Donovan DT.Causes and consequences of adult laryngotracheal stenosis.Laryngoscope2015;125:1137-43 PMCID:PMC4562418

[2] Ramalingam H,Pathak V,Rathod DK.Delayed diagnosis of postintubation tracheal stenosis due to the coronavirus disease 2019 pandemic: a case report.A A Pract2020;14:e01269 PMCID:PMC7323828

[3] Stauffer JL,Petty TL.Complications and consequences of endotracheal intubation and tracheotomy.Am J Med1981;70:65-76

[4] Jamil A,Schwartz GS,Mason DP.Tracheal resection for tracheal stenosis.Proc (Bayl Univ Med Cent)2020;33:15-8 PMCID:PMC6988649

[5] Bhora FY,Forleiter CM.Treatment of benign tracheal stenosis using endoluminal spray cryotherapy.JAMA Otolaryngol Head Neck Surg2016;142:1082-7

[6] Nouraei SA,Patel A,Sandhu GS.Estimating the population incidence of adult post-intubation laryngotracheal stenosis.Clin Otolaryngol2007;32:411-2

[7] Prokakis C,Dedeilias P,Filos K.Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment.J Cardiothorac Surg2014;9:117 PMCID:PMC4104740

[8] Baig MZ,Connery CP.A SEER database cohort of 868 patients with primary tracheal cancers: characteristics and outcomes and the role of bronchoscopic interventions.IJS Oncology2021;5:90

[9] Urdaneta AI,Wilson LD.Population based cancer registry analysis of primary tracheal carcinoma.Am J Clin Oncol2011;34:32-7

[10] Agrawal S,Celie KB.Survival trends in patients with tracheal carcinoma from 1973 to 2011.Am J Otolaryngol2017;38:673-7

[11] BELSEY R.Resection and reconstruction of the intrathoracic trachea.Br J Surg1950;38:200-5

[12] Kirschbaum A,Suárez C.Treatment of large tracheal defects after resection: laryngotracheal release and tracheal replacement.Auris Nasus Larynx2016;43:602-8 PMCID:PMC5152768

[13] Broussard B.Tracheal release maneuvers.Ann Cardiothorac Surg2018;7:293-8 PMCID:PMC5900085

[14] Tsang V,Gillbe C.Slide tracheoplasty for congenital funnel-shaped tracheal stenosis.Ann Thorac Surg1989;48:632-5

[15] Sidell DR,Tabangin ME.Revision thoracic slide tracheoplasty: outcomes following unsuccessful tracheal reconstruction.Laryngoscope2018;128:2181-6

[16] Redmann AJ,de Alarcon A.Cervical slide tracheoplasty in adults with laryngotracheal stenosis.Laryngoscope2019;129:818-22

[17] Delaere P.Tracheal replacement.J Thorac Dis2016;8:S186-96 PMCID:PMC4775267

[18] Doss AE,Kucera KA,Zwischenberger JB.Tracheal replacements: part 2.ASAIO J2007;53:631-9

[19] Etienne H,Gomez Caro A.Tracheal replacement.Eur Respir J2018;51:1702211

[20] Neville WE,Kotia GG.Clinical experience with the silicone tracheal prosthesis.J Thorac Cardiovasc Surg1990;99:604-12; discussion 612-3

[21] Toomes H,Vogt-Moykopf I.Experiences with prosthetic reconstruction of the trachea and bifurcation.Thorax1985;40:32-7 PMCID:PMC459974

[22] Schultz P,Chluba J,Debry C.Survival analysis of rats implanted with porous titanium tracheal prosthesis.Ann Thorac Surg2002;73:1747-51

[23] Debry C,Vrana NE,Lavalle P.Laryngeal replacement with an artificial larynx after total laryngectomy: the possibility of restoring larynx functionality in the future.Head Neck2014;36:1669-73

[24] Fabre D,Fadel E.Successful tracheal replacement in humans using autologous tissues: an 8-year experience.Ann Thorac Surg2013;96:1146-55

[25] Grillo HC.Tracheal replacement: a critical review.Ann Thorac Surg2002;73:1995-2004

[26] Ren YJ,Shen LX.A novel technique of long-segment tracheal repair with extended bronchial flap of right upper and main bronchus plus tracheoplasty.Ann Thorac Surg2015;99:2188-90

[27] Abouarab AA,Elkhayat H,Cleveland DC.Current solutions for long-segment tracheal reconstruction.Ann Thorac Cardiovasc Surg2017;23:66-75 PMCID:PMC5422631

[28] Fukunaga Y,Miyamoto S.One-stage reconstruction of a tracheal defect with a free radial forearm flap and free costal cartilage grafts.J Plast Reconstr Aesthet Surg2014;67:857-9

[29] Teng MS,Urken ML.Prefabricated composite free flaps for tracheal reconstruction: a new technique.Ann Otol Rhinol Laryngol2005;114:822-6

[30] Beldholm B,Gallagher R,King M.Reconstruction of the trachea with a tubed radial forearm free flap.J Thorac Cardiovasc Surg2003;126:545-50

[31] Yu P,Walsh GL.Human tracheal reconstruction with a composite radial forearm free flap and prosthesis.Ann Thorac Surg2006;81:714-6

[32] Ko PJ,Wu YC.Granulation formation following tracheal stenosis stenting: influence of stent position.Laryngoscope2009;119:2331-6

[33] Azorin JF,Martinod E.Tracheal replacement with an aortic autograft.Eur J Cardiothorac Surg2006;29:261-3

[34] Wurtz A,Conti M.Surgical technique and results of tracheal and carinal replacement with aortic allografts for salivary gland-type carcinoma.J Thorac Cardiovasc Surg2010;140:387-93.e2

[35] Jacobs JP,Andrews T.Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences.Ann Thorac Surg1999;68:1043-51

[36] Jacobs JP,Haw MP,Herberhold C.Pediatric tracheal homograft reconstruction: a novel approach to complex tracheal stenoses in children.J Thorac Cardiovasc Surg1996;112:1549-60

[37] Propst EJ,Meinzen-Derr J,Cotton RT.Pediatric tracheal reconstruction using cadaveric homograft.Arch Otolaryngol Head Neck Surg2011;137:583-90

[38] Levashov Y,Cherny S,Shafirovsky B.One-stage allotransplantation of thoracic segment of the trachea in a patient with idiopathic fibrosing mediastinitis and marked tracheal stenosis.Eur J Cardiothorac Surg1993;7:383-6

[39] Rose K,Wustrow F.Tracheal allotransplantation in man.Lancet1979;313:433

[40] Delaere P,Verleden G,Van Raemdonck D.Leuven Tracheal Transplant GroupTracheal allotransplantation after withdrawal of immunosuppressive therapy.N Engl J Med2010;362:138-45

[41] Xu L,Li J.Human tracheal allotransplant with greater omentum for revascularization.Exp Clin Transplant2014;12:448-53.

[42] Lancet. The final verdict on Paolo Macchiarini: guilty of misconduct.Lancet2018;392:2

[43] Cyranoski D.Surgeon commits misconduct: papers authored by Paolo Macchiarini misrepresented success of pioneering tracheal transplant procedure.Nature2015;521:406-8

[44] Langer R.Designing materials for biology and medicine.Nature2004;428:487-92

[45] Langer R.Tissue engineering.Science1993;260:920-6

[46] Law JX,Aminuddin BS.Tissue-engineered trachea: a review.Int J Pediatr Otorhinolaryngol2016;91:55-63

[47] Butler CR,Gowers KH.Rapid expansion of human epithelial stem cells suitable for airway tissue engineering.Am J Respir Crit Care Med2016;194:156-68 PMCID:PMC5003214

[48] Nomoto M,Tada Y.Bioengineered trachea using autologous chondrocytes for regeneration of tracheal cartilage in a rabbit model.Laryngoscope2013;123:2195-201

[49] Hamilton NJI,Gowers KHC.Bioengineered airway epithelial grafts with mucociliary function based on collagen IV- and laminin-containing extracellular matrix scaffolds.Eur Respir J2020;55:1901200 PMCID:PMC7301290

[50] Conconi MT,Di Liddo R.Tracheal matrices, obtained by a detergent-enzymatic method, support in vitro the adhesion of chondrocytes and tracheal epithelial cells.Transpl Int2005;18:727-34

[51] Zhao L,Le AV.Engineered tissue-stent biocomposites as tracheal replacements.Tissue Eng Part A2016;22:1086-97 PMCID:PMC5312617

[52] Bhora FY,Rehmani SS.Circumferential three-dimensional-printed tracheal grafts: research model feasibility and early results.Ann Thorac Surg2017;104:958-63

[53] Rehmani SS,Ayub A.Three-dimensional-printed bioengineered tracheal grafts: preclinical results and potential for human use.Ann Thorac Surg2017;104:998-1004

[54] Al-Ayoubi AM,Sinclair CF,Bhora FY.Reconstruction of anterior tracheal defects using a bioengineered graft in a porcine model.Ann Thorac Surg2017;103:381-9

[55] Gilbert TW,Badylak SF.Quantification of DNA in biologic scaffold materials.J Surg Res2009;152:135-9 PMCID:PMC2783373

[56] Morris AH,Kyriakides TR.Inadequate processing of decellularized dermal matrix reduces cell viability in vitro and increases apoptosis and acute inflammation in vivo.Biores Open Access2016;5:177-87 PMCID:PMC4948200

[57] Cramer MC.Extracellular matrix-based biomaterials and their influence upon cell behavior.Ann Biomed Eng2020;48:2132-53 PMCID:PMC7231673

[58] Grimmer JF,Alsberg E.Tracheal reconstruction using tissue-engineered cartilage.Arch Otolaryngol Head Neck Surg2004;130:1191-6

[59] Lee CJ,Choi H,Min BH.Tissue engineered tracheal prosthesis with acceleratedly cultured homologous chondrocytes as an alternative of tracheal reconstruction.J Cardiovasc Surg (Torino)2002;43:275-9

[60] Kang JY,Sung JH.Novel porous matrix of hyaluronic acid for the three-dimensional culture of chondrocytes.Int J Pharm2009;369:114-20

[61] Weidenbecher M,Gilpin DA.Tissue-engineered trachea for airway reconstruction.Laryngoscope2009;119:2118-23 PMCID:PMC4811374

[62] Dikina AD,Lai BP,Alsberg E.Engineered cartilaginous tubes for tracheal tissue replacement via self-assembly and fusion of human mesenchymal stem cell constructs.Biomaterials2015;52:452-62 PMCID:PMC4379457

[63] Komura M,Kanamori Y.An animal model study for tissue-engineered trachea fabricated from a biodegradable scaffold using chondrocytes to augment repair of tracheal stenosis.J Pediatr Surg2008;43:2141-6

[64] Hamaji M,Koyasu S.Development of a composite and vascularized tracheal scaffold in the omentum for in situ tissue engineering: a canine model.Interact Cardiovasc Thorac Surg2014;19:357-62

[65] Gao B,Gao M.Long-segmental tracheal reconstruction in rabbits with pedicled Tissue-engineered trachea based on a 3D-printed scaffold.Acta Biomater2019;97:177-86

[66] Luo X,Zhang Z.Long-term functional reconstruction of segmental tracheal defect by pedicled tissue-engineered trachea in rabbits.Biomaterials2013;34:3336-44

[67] Gao M,Dong W.Tissue-engineered trachea from a 3D-printed scaffold enhances whole-segment tracheal repair.Sci Rep2017;7:5246 PMCID:PMC5507982

[68] Kojima K,Roy AK,Cortiella J.Autologous tissue-engineered trachea with sheep nasal chondrocytes.J Thorac Cardiovasc Surg2002;123:1177-84