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Thorac Cardiovasc Surg 2022; 70(06): 513-519
DOI: 10.1055/s-0041-1740308
Original Thoracic

An Experimental Study on Timing in Tracheal Stenosis Surgery

Umit Aydogmus
1   Department of Thoracic Surgery, Pamukkale University Hospital, Denizli, Turkey
,
Gokhan Ozturk
1   Department of Thoracic Surgery, Pamukkale University Hospital, Denizli, Turkey
,
Argun Kis
1   Department of Thoracic Surgery, Pamukkale University Hospital, Denizli, Turkey
,
Yeliz Arman Karakaya
2   Department of Medical Pathology, Pamukkale University Hospital, Denizli, Turkey
,
Hulya Aybek
3   Department of Medical Biochemistry, Pamukkale University Hospital, Denizli, Turkey
,
Ferda Bir
2   Department of Medical Pathology, Pamukkale University Hospital, Denizli, Turkey
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Abstract

Background TNF-α, IL-6, and TGF-β are important bio mediators of the inflammatory process. This experimental study has investigated inflammatory biomarkers' efficacy to determine the appropriate period for anastomosis surgery in tracheal stenosis cases.

Methods First, a pilot study was performed to determine the mean stenosis ratio (SR) after the surgical anastomosis. The trial was planned on 44 rats in four groups based on the pilot study's data. Tracheal inflammation and stenosis were created in each rat by using micro scissors. In rats of groups I, II, III, and IV, respectively, tracheal resection and anastomosis surgery were applied on the 2nd, 4th, 6th, 8th weeks after the damage. The animals were euthanized 8 weeks later, followed by histopathological assessment and analysis of TNF-α, IL-6, and TGF-β as biochemical markers.

Results Mean SR of the trachea were measured as 21.9 ± 6.0%, 24.1 ± 10.4%, 25.8 ± 9.1%, and 19.6 ± 9.2% for Groups I to IV, respectively. While Group III had the worst SR, Group IV had the best ratio (p = 0.03). Group II had the highest values for the biochemical markers tested. We observed a statistically significant correlation between only histopathological changes and TNF-α from among the biochemical markers tested (p = 0.02). It was found that high TNF-α levels were in a relationship with higher SR (p = 0.01).

Conclusion Tracheal anastomosis for post-traumatic stenosis is likely to be less successful during the 4th and 6th weeks after injury. High TNF-α levels are potentially predictive of lower surgical success. These results need to be confirmed by human studies.

Keywords

trachea - tracheal stenosis - tracheal inflammation - stenosis - inflammatory biomarkers

Ethics

Ethics committee approval was obtained for this study from the Animal Local Ethics Committee. The care and comfort of the rats were attained by an experienced veterinary and his assistants. All rats were cared for in accordance with the “Principles of Laboratory Animal Care” and the “Guide for the Care and Use of Laboratory Animals” prepared by National Academies Press. All procedures including the sacrifice were performed under deep anesthesia.




Publication History

Received: 07 September 2021

Accepted: 07 September 2021

Article published online:
28 December 2021

© 2021. Thieme. All rights reserved.

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