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Donor aortic graft improves reconstruction after partial laryngectomy
Date:5/21/2012

The MGH surgeons first used a previously frozen aortic graft for reconstruction after partial laryngectomy for recurrent cancer in 2009. Over the next two years, they performed the procedure on 15 patients, 8 of whom had previously received radiation therapy. All of these procedures were performed in one operation, combining both the tumor removal and reconstruction at the same time, and no immunosuppressive medications were needed.

Of that initial group of patients, all were able to have their postoperative tracheotomy tubes removed and resume breathing normally. All resumed speaking without the need for assistive devices, although their vocal quality depended on how much tissue had been removed, and all but one recovered and maintained swallowing function. Two patients had recurrence of their advanced tumors that required subsequent total laryngectomy. No stents were needed to keep patients' airways open, unlike in pilot trials using similar aortic grafts to reconstruct the trachea, which have had limited success.

"The shape of the aorta, which approximates that of the removed laryngeal tissue, and its ability to serve as a surface for healing within the airway are unique characteristics of these grafts that other forms of reconstruction do not provide," says Wain.

Zeitels adds, "The success of this procedure is remarkable, since the aortic tissue has held up extremely well against the stresses of a non-sterile environment, exposure to refluxing stomach fluids and the mechanical forces of swallowing and coughing. Given the success in this extremely challenging surgical scenario, it's likely that there will be many other uses for cryopreserved vascular grafts as supportive structures and tissue patches for surgery in other parts of the body."


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Contact: Mike Morrison
mdmorrison@partners.org
617-724-6425
Massachusetts General Hospital
Source:Eurekalert

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