Technique Shows Promise for Reconstruction of Airway Following Surgery

JAMA

EMBARGOED FOR RELEASE: 12:15 P.M. (ET), SUNDAY, MAY 20, 2018

Media advisory: To contact corresponding author Emmanuel Martinod, M.D., Ph.D., email emmanuel.martinod@aphp.fr. The full study is available on the For The Media website.

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Bottom Line: An early study suggests it may be feasible to use human aortic grafts preserved by freezing to rebuild windpipe and airway sections removed because of disease.

Why The Research Is Interesting: Airway replacement could potentially benefit many patients with lung cancer and be an option for patients with end-stage tracheobronchial disease.

Who and When: 20 patients with lung tumors or tracheal lesions, of which 13 patients had diseased airway sections removed and underwent airway transplantation (5 tracheal, 7 bronchial and 1 carinal, which is where the trachea divides into the bronchi of the lungs); study conducted from October 2009 through February 2017, with final patient follow-up in November 2017

What (Study Measures): Airway transplantation using a cryopreserved aortic graft and custom-made stent inserted into the graft to keep the airway from collapsing but was later removed (exposure); 90-day morality (primary outcome)

How (Study Design): This was a cohort study where people were followed over time.

Authors: Emmanuel Martinod, M.D., Ph.D., Assistance Publique-Hopitaux de Paris, Bobigny, France, and coauthors

Results:

Study Limitations: Limited number of patients in this feasibility study at a single center without a comparison group; larger studies needed to further assess effectiveness and safety

Study Conclusions: This study demonstrated the feasibility for complex tracheal and bronchial reconstruction.

Featured Image:

What The Image Shows: (Click on the image for a full-size version. Right click to “save image as” to download.) Illustration of airway reconstruction method.

Related material: The editorial, “Has Reconstruction of the Central Airways Been Transformed?” by Valerie W. Rusch, M.D., Memorial Sloan Kettering Cancer Center, New York; JAMA Medical News & Perspectives article, “The Body’s Largest Artery Aids in Building a Better Trachea,” and an author podcast with Emmanuel Martinod, M.D., Ph.D., are also available on the For The Media website.

For more details and to read the full articles, please visit the For The Media website.

(doi:10.1001/jama.2018.4653)

Editor’s Note:  This study is being published to coincide with its presentation at the American Thoracic Society International Conference. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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