PMC9869265_01
(A) Preoperative CT scan of the thorax. The white arrow indicates a tracheal tumor. (B) 3D model of the trachea with tumor. (C) 3D custom-made carbon fiber stent before tailoring. (D) Trachea defect caused by tumor resection. (E) Defect repaired by using an autologous pericardial patch. The white arrow indicates a pericardial patch. Airway ventilation will cause a patch float at this point. (F) Custom-made carbon fiber stent fixed outside the patch for suspension to abolish a pericardial patch float.
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F1
CT showed that the tumor was located in the right lateral wall of both the trachea and the right main bronchus (Figure 1A). First, a 3D model of the trachea and tumor was created by using MIMICS software (Materialise Magics; Materialise Software, Leuven, Belgium) with CT data (Figure 1B). Next, a custom-made carbon fiber stent was prepared with the carbon fiber 3D sintering printing technique (Tankang biotech, Changsha, China) (Figure 1C). Tumor resection caused a 4 cm length defect in the trachea and the right main bronchus (Figure 1D). A right anterior autologous pericardial patch was first resected and trimmed to repair the defect by a continuous suture with a 3-0 absorbable suture, then the carbon fiber stent was tailored to an appropriate size and fixed outside the patch for suspension to abolish the pericardial patch float (Figures 1E,F), and then, the stent was fixed by an interrupted suture with the 3-0 absorbable suture.
Fiberoptic bronchoscopy on the day of surgery (A), 10 days after surgery (B), and 6 months later (C). Fiberoptic bronchoscopy 6 months later showing a smooth mucosal on the inner surface of the repaired trachea. (D,E) Postoperative CT scan and 3D tracheal imaging 3 years later showing no tracheal stenosis or obstruction.
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F2
The operation was very successful, and fiberoptic bronchoscopy showed a clear airway (Figure 2A). Fiberoptic bronchoscopy performed 10 days after the surgery showed a clear airway with a thin layer of inflammatory exudation on the pericardial patch (Figure 2B), and the patient was discharged the next day. Fiberoptic bronchoscopy 6 months later showed a smooth mucosal on the inner surface of the repaired trachea (Figure 2C), and the pulmonary function tests showed a normal ventilatory and diffuse function. CT scans showed no tracheal stenosis or obstruction during a 3-year follow-up (Figures 2D,E).