Polytetrafluoroethylene graft in a long segment of the esophagus]

Treatment for long segment circular defects of the trachea still represent a challenge. Short-segment lesions can be treated with primary reconstruction. Segmental grafting is necessary if primary reconstruction is impossible. We investigated the use of politetrafluoroethylene (PTFE) grafts for tracheal grafting. Forty-nine adult New Zealand white rabbits were divided in 7 groups in which we compared the effects of continuous and interrupted suture techniques, and various positioning of the graft. Length of survival, changes in intraoperative tracheal microcirculation were measured, microscopic alterations of the trachea, and the anastomosis were studied. Continuous sutures significantly decreased local microcirculation. Using interrupted sutures this effect was not seen. The frequent development of granulation tissue was reduced by using internal telescopic anastomosis. We found that PTFE graft with internal telescopic anastomosis using interrupted sutures is superior to all other techniques.