Due to a congenital narrowing of the trachea (tracheal stenosis), a complete reconstruction of this organ was performed in a 12-year-old girl, from her own tissues. Carried out in 2014 by a surgical team from the Necker-Enfants Malades hospital in Paris, the operation was a success: now 16 years old, the young girl can breathe and live normally. A world first for a child.
This is a world first: uhe 12-year-old young patient suffering from congenital narrowing of the trachea and the bronchi which originate from it (stem bronchi) underwent a complete reconstruction of this organ in 2014 from her own tissues. On April 5, his doctors rejoiced in the New England Journal of Medicine (NEJM) that the young girl, now aged 16, can now breathe and live normally.
Operated for the first time at 9 months while her vital prognosis was engaged, the patient underwent several other operations during her childhood, which saved his life, but failed to restore a satisfactory tracheal caliber due to his growth. And for good reason: if this This operation was developed for adults in 2010 by doctors from the Marie Lannelongue hospital and the Gustave Roussy institute, it remains particularly complex to perform in children.
A world first
Finally the victim of an acute respiratory deterioration (potentially fatal) in 2014, the teams of the IGR, Marie Lannelongue and Necker-Enfant patients urgently operated on the young teenager. As the images in their article show, the artificial trachea was made from the flap of a muscle from the patient’s back, covered with skin and reinforced with pieces of cartilage taken from her ribs. Everything was sewn to form a tube (and simulate the shape of the trachea). Then the cylinder was removed about ten days after the operation.
Correspondence: 4-Year Follow-up in a Child with a Total Autologous Tracheal Replacement https://t.co/TdYXvVULEq pic.twitter.com/z21wavxV0i
– NEJM (@NEJM) April 5, 2018
“In the absence of currently reliable alternative techniques (in particular those using cell and tissue biotherapy), this first worldwide success appears to be an indisputable advance in the management of severe and extensive pediatric tracheal damage”, underlines the AP -HP in a communicated.
A series of successes
This success is reminiscent of that which occurred in Toulouse last year. In February 2017, the Toulouse University Hospital had indeed performed the first tailor-made trachea transplant in the world, from patient scans. This first was published in theAmerican Journal of Respiratory and Critical Care Medicine.
The team behind the transplant detailed the care of a patient whose airways had narrowed following a lung transplant. Doctors performed a scanner, from which a 3D model of the airway was produced. Then the start-up AnatomikModeling made a mold adapted to the anatomy of the volunteer. It made it possible to create a unique model, based on a medical silicone elastomer, which was successfully implanted at the CHU.
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