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Abdominal compartment syndrome occurs when 2 or more anatomic compartments have a sustained intra-abdominal pressure >20 mmHg, associated with organ failure. Incidence is 2% and prevalence varies from 0% to 36.4%.A literature search was conducted utilizing different databases. Articles published from 1970 to 2018 were included, in English or Spanish, to provide the concepts, classifications, and comprehensive management in the approach to abdominal compartment syndrome, for its treatment and the prevention of severe complications associated with the entity. Intravesical pressure measurement is the standard diagnostic method. Treatment is based on evacuation of the intraluminal content, identification and treatment of intra-abdominal lesions, improvement of abdominal wall compliance, and optimum administration of fluids and tissue perfusion. Laparotomy is generally followed by temporary abdominal wall closure 5–7 days after surgery. Reconstruction is performed 6–12 months after the last operation.Abdominal compartment syndrome should be diagnosed and operated on before organic damage from the illness occurs. Kidney injury can frequently progress and is a parameter for considering abdominal decompression. Having a biomarker for early damage would be ideal. Surgical treatment is successful in the majority of cases. A multidisciplinary focus is necessary for the intensive care and reconstructive needs of the patient. Thus, efforts must be made to define and implement strategies for patient quality of life optimization. Resumen: El síndrome compartimental abdominal se define cuando 2 o más compartimentos anatómicos tienen una presión intraabdominal con valor sostenido > 20 mmHg, asociado a una falla orgánica. La incidencia es del 2% y la prevalencia del 0 al 36.4%.Se realizó la búsqueda bibliográfica en diferentes bases de datos. Se incluyeron artículos publicados desde 1970 al 2018, en inglés o español, con el fin de proporcionar los conceptos, clasificaciones y manejo integral en el abordaje del síndrome compartimental, para tratar y evitar complicaciones severas en los pacientes asociados a dicha entidad.La medición de la presión intravesical es el método estándar para el diagnóstico. El tratamiento se basa en la evacuación de contenidos intraluminales, identificar y tratar las lesiones intraabdominales, mejorar la complianza de la pared abdominal, y la óptima administración de fluidos y perfusión tisular. La laparotomía es generalmente seguida de un cierre temporal de la pared abdominal de 5 a 7 días después de la cirugía. La reconstrucción es realizada de 6 a 12 meses después de la última operación.Se debe diagnosticar e intervenir antes del daño orgánico ocasionado por el síndrome compartimental abdominal. Con frecuencia la lesión renal puede progresar, siendo este un parámetro para considerar la descompresión abdominal. Contar con un biomarcador de daño temprano sería ideal. El tratamiento quirúrgico es exitoso en la mayoría. Un enfoque multidisciplinario es necesario para los cuidados intensivos y necesidades reconstructivas del paciente, por lo que es preciso seguir trabajando para definir e implementar estrategias que mitiguen la calidad de vida del paciente.

Introduction and Aims: Insulin-like growth factor 1 is modulated by the insulin-like growth factor-binding proteins (IGFBPs) that are synthesized in the liver. The aim of the present study was to evaluate the concentrations of IGFBPs 1–7 in patients with chronic hepatitis C and study their association with fibrosis stage. Patients and methods: A prospective, cross-sectional study was conducted that included patients with chronic hepatitis C. The stages of fibrosis were determined through FibroTest and FibroScan and the patients were compared with a control group. Serum levels of IGFBPs 1–7 were quantified through multiple suspension arrays. The Kruskal-Wallis test, Mann-Whitney U test, Spearman’s correlation, and ROC curves were used for the statistical analysis. Results: Upon comparing the patients and controls, the highest concentrations were found in IGFBPs 1, 2, 4, and 7 (p = 0.02, 0.002, 0.008, and

Noninvasive methods for liver disease diagnoses offer great advantages over biopsy, but they cannot be utilized in all cases. Therefore, specific indicators for chronic liver disease management are necessary. The aim was to assess the production of insulin-like growth factor-binding proteins (IGFBPs) 1-7 and their correlation with the different stages of fibrosis in chronic hepatitis C (CHC). A prospective, cross-sectional, multicenter study was conducted. CHC patients were categorized by FibroTest® and/or FibroScan®. Serum concentrations of IGFBPs 1-7 were determined through multiple suspension arrangement array technology. Significant differences were validated by the Kruskal-Wallis and Mann-Whitney U tests. Logistic regression models were performed to assess the association between the IGFBPs and fibrosis stages. The association was determined utilizing odds ratios (ORs), and receiver operating characteristic (ROC) curves were constructed to distinguish the IGFBPs in relation to the diagnosis of fibrosis. IGFBP-1 and IGFBP-7 concentrations were higher in CHC than in the healthy individuals, whereas IGFBP-3, IGFBP-5, and IGFBP-6 were downregulated in the patients. An apparent increase of all the IGFBPs was found at fibrosis stage F4, but with different regulations. IGFBP-2, -4, -6, and -7 had the best OR, showing the relation to fibrosis progression. The ROC curves showed that IGFBP-7 was the only protein that distinguished F1 from F3 and F2 from F3. IGFBPs participate in liver fibrosis progression and could be employed as circulating novel protein panels for diagnosis and as possible therapeutic targets in liver fibrosis progression.

Cecal volvulus is a rare cause of intestinal obstruction, with multifactorial etiologies. This is a case report describing a 52-year-old female with a cecal volvulus diagnosis made during the laparotomy procedure, which was treated with a right hemicolectomy with a side-to-side ileotransverse anastomosis. The aim of this report is to emphasize the importance of a diagnosis and appropriate treatment in this rare pathology in abdominal procedures. In this particular case, the patient benefited from an early surgical intervention without further complications, as well as an adequate postoperative evolution; it is important to acknowledge and consider this pathology during differential diagnosis, and not delay the treatment in patients with cecal volvulus. A critical review of the literature is included and discussed.

Colorectal cancer is one of the main neoplasms worldwide; at the time of diagnosis about 25% of cases already have an advanced stage with the presence of metastases. A 58-year-old female presented with nausea, vomiting, and black stools and diffuse abdominal pain associated with 7% weight loss. She was referred to our hospital with signs of digestive tract bleeding and anemic syndrome. Panendoscopy revealed body and fundus gastropathy and presence of Helicobacter pylori, and colonoscopy showed a neoplastic lesion at the ascending colon level. A synchronous resection was performed in a single surgical time of colorectal cancer and liver metastases with a duration of 4 h and bleeding of 900 mL. The oral feeding started 24 h after surgery, presenting gas channeling at 24 h and evacuations at 48 h. The total intrahospital stay was 5 days. Synchronous resection of hepatic metastases in colorectal cancer is still rarely performed, despite the fact that in recent years the number of cases has increased because of better surgical techniques. Synchronous resection of colorectal cancer and liver metastases can be performed safely, without increasing transoperative mortality when performed in specialized centers with a multidisciplinary team; however, it is essential to emphasize the importance of negative surgical margins (R0) of the primary tumor and later to be complemented with adjuvant treatment with chemotherapy.

Introduction Acute appendicitis is the most common abdominal urgency around the world. Recent studies have investigated the efficacy of platelet distribution width (PDW) in the diagnosis of acute appendicitis. Objectives To determine if there is a correlation between PDW and the diagnosis of patients with acute appendicitis and to define their relation to the phases of appendicitis. Method A case-controlled study was conducted in two population groups with 41 patients older than 18 years of age diagnosed with acute appendicitis (group I) and 41 healthy patients (group II). Statistical analysis was performed using SPSS software version 21. Results An average age of 37.27 ± 15.6 years was observed. The largest number of cases with acute appendicitis were presented in phase III. The total number of leukocytes and the percentage of neutrophils presented significant differences in the statistics. It was observed that there is no association between the appendicitis phase and the PDW values. Conclusion There are no differences between PDW values of patients with acute appendicitis compared to healthy patients, nor PDW ratio with the phases of appendicitis.

Background Several guidelines have put forward recommendations about the perioperative process of cholecystectomy. Despite the recommendations, controversy remains concerning several topics, especially in low- and middle-income countries. The aim of this study was to develop uniform recommendations for perioperative practices in cholecystectomy in Mexico to standardize this process and save public health system resources. Methods A modified Delphi method was used. An expert panel of 23 surgeons anonymously completed two rounds of responses to a 29-item questionnaire with 110 possible answers. The consensus was assessed using the percentage of responders agreeing on each question. Results From the 29 questions, the study generated 27 recommendations based on 20 (69.0%) questions reaching consensus, one that was considered uncertain (3.4%), and six (20.7%) items that remained open questions. In two (6.9%) cases, no consensus was reached, and no recommendation could be made. Conclusions This study provides recommendations for the perioperative management of cholecystectomy in public hospitals in Mexico. As a guide for public institutions in low- and middle-income countries, the study identifies recommendations for perioperative tests and evaluations, perioperative decision making, postoperative interventions and institutional investment, that might ensure the safe practice of cholecystectomy and contribute to conserving resources.

The most common malignancy of the biliary tract, gallbladder cancer (GBC) often has a dismal prognosis. The aggressive nature of the tumor, delayed diagnosis at advanced stages of the disease, and lack of effective treatment options are some of the factors that contribute to a poor outcome. Early detection and accurate assessment of disease burden is critical to optimize management and improve long-term survival, as well as identify patients for adjuvant therapy and clinical trials. With recent advances in the understanding of the molecular pathogenesis of GBC, several specific diagnostic and biomarkers have been proposed as being of diagnostic and prognostic importance. Indeed, identification of novel diagnostic and prognostic markers has an important role in early diagnosis and development of targeted therapies among patients with GBC. Next-generation sequencing technology and genomewide data analysis have provided novel insight into understanding the molecular pathogenesis of biliary tract cancers, thereby identifying potential biomarkers for clinical use. We herein review available GBC biomarkers and the potential clinical implications in the management of GBC.

The liver is the most common site of metastasis in patients with colorectal cancer due to its anatomical situation regarding its portal circulation. About 14 to 18% of patients with colorectal cancer present metastasis at the first medical consultation, and 10 to 25% at the time of the resection of the primary colorectal cancer. The incidence is higher (35%) when a computed tomography (CT) scan is used. In the last decades, a significant increase in the life expectancy of patients with colorectal cancer has been achieved with different diagnostic and treatment programs. Despite these improvements, the presence of metastasis, disease recurrence, and advanced local tumors continue to remain poor prognostic factors. Median survival without treatment is It is very important to have knowledge of predisposing factors, diagnostic methods, and treatment of hepatic metastasis. However, the establishment of newer, efficient, preventive screening programs for early diagnosis and adequate treatment is vital. How to cite this article Valderrama-Treviño AI, Barrera-Mera B, Ceballos-Villalva JC, Montalvo-Javé EE. Hepatic Metastasis from Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(2):166-175.

Background The Doctor of Philosophy is the highest academic degree that can be obtained in universities. Graduate Education Programme in Medicine in Mexico is divided into 2 major categories: Medical Specialty and Master studies/Doctor of Philosophy. The objective of this study was to demonstrate the importance of master's degrees and Doctor of Philosophy in general surgery. Material and methods A literature search in PubMed and Medline among others, from 1970 to 2015 with subsequent analysis of the literature reviews found. Discussion The physicians who conducted doctoral studies stand out as leaders in research, teaching and academic activities. Dual training with a doctorate medical specialty is a significant predictor for active participation in research projects within the best educational institutions. Results It is important to study a PhD in the education of doctors specialising in surgery, who show more training in teaching, research and development of academic activities. Currently, although there is a little proportion of students who do not finish the doctoral programme, the ones who do are expected to play an important role in the future of medical scientific staff. It has been shown that most doctors with Doctor of Philosophy have wide range of career options. Conclusion The importance of doctoral studies in the formation of general surgery is due to various reasons; the main one being comprehensively training physician scientists who can develop in clinical, teaching and research.

We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the pain did not improve with symptomatic management. A laparoscopic cholecystectomy due to acute lithiasic cholecystitis was performed. However, after 4 days, postoperative painless jaundice was evident; thus, endoscopic retrograde cholangiopancreatography was performed, which revealed an amputation of intrapancreatic common bile duct, as well as secondary intra- and extrahepatic bile duct dilatation. Brushing of the distal portion of the common bile duct revealed a well-differentiated adenocarcinoma. Therefore, a Whipple procedure with pylorus preservation was performed. Pathologic diagnosis of a papillary in situ adenocarcinoma with two microscopic foci of microinvasion was established. The pathologic Tumor-Node-Metastasis (TNM) stage was pT1, pN0, pM0, R0. The patient is asymptomatic and disease-free 24 months after surgery. In general, adenocarcinomas of the extrahepatic bile ducts are uncommon and have a poor prognosis. However, symptomatic patients with early disease stages are even rarer and can be cured surgically.

Background: Influenza is an acute respiratory disease responsible for several episodes of high mortality throughout human history. In 2009, Mexico experienced an atypical influenza outbreak caused by a mutant strain of the influenza A (H1N1) subtype, which generated significant mortality. The aim of this paper was to analyze the clinical and sociodemographic conditions of the first 1000 fatalities recorded during this outbreak. Methods: We conducted a study based on an analysis of the clinical files of patients positive for influenza A (H1N1) using Real-Time-Polymerase Chain Reaction (RT-PCR) to conduct an analysis of deaths compared to deaths in the general population. Results: The majority of deaths occurred in patients aged 35-84 years (65.8%). Average time between symptom onset and death was 13.8 days, with an average of 7.8 days from time of hospitalization until death. Ca. 25% of deaths occurred in residents from Mexico City and from the nearby State of Mexico. In the majority of cases, we found that patients who died had a low educational and socioeconomic status along with co-morbidities such as metabolic syndrome and its individual components, as well as respiratory illnesses. In 80% of cases, patients received mechanical ventilation, and a similar percentage received antiviral therapy (oseltamivir, zanamivir). Conclusions: The primary-care level was not utilized by patients who died from influenza. The higher prevalence of chronic degenerative diseases among deaths compared with the general population indicates that these groups of patients should be considered and prioritized in the event of future outbreaks.

Nonalcoholic steatohepatitis is one of the leading causes of liver disease. Dietary factors determine the clinical presentation of steatohepatitis and can influence the progression of related diseases. Cholesterol has emerged as a critical player in the disease and hence consumption of cholesterol-enriched diets can lead to a progressive form of the disease. The aim was to investigate the impact of liver cholesterol overload on the progression of the obstructive cholestasis in mice subjected to bile duct ligation surgery. Mice were fed with a high cholesterol diet for two days and then were subjected to surgery procedure; histological, biochemical, and molecular analyses were conducted to address the effect of cholesterol in liver damage. Mice under the diet were more susceptible to damage. Results show that cholesterol fed mice exhibited increased apoptosis and oxidative stress as well as reduction in cell proliferation. Mortality following surgery was higher in HC fed mice. Liver cholesterol impairs the repair of liver during obstructive cholestasis and aggravates the disease with early fatal consequences; these effects were strongly associated with oxidative stress., This work was supported by grants of the CONACYT 252942, 236558, and 166042, CONACYT Fronteras de la Ciencia 1320, Asociación Mexicana de Hepatología, and SEP-PRODEP-913026-1461211, Universidad Autónoma Metropolitana Iztapalapa, by grants SAF-2011-23031 and SAF-2012-34831 from Plan Nacional de I+D, Spain, Fundació la Marató de TV3, La Mutua Madrileña, PI11/0325 (META) Grant from the Instituto Salud Carlos III, by the support of CIBEREHD, and by the Center Grant P50-AA-11999 from Research Center for Liver and Pancreatic Diseases funded by NIAAA/NIH.

A diverticulum is a bulging sack in any portion of the gastrointestinal tract. The most common site for the formation of diverticula is the large intestine. Small intestine diverticular disease is much less common than colonic diverticular disease. The most common symptom is non-specific epigastric pain and a bloating sensation. Major complications include diverticulitis, gastrointestinal bleeding, acute perforation, pancreatic or biliary (in the case of duodenal diverticula) disease, intestinal obstruction, intestinal perforation, localized abscess, malabsorption, anemia, volvulus and bacterial overgrowth. We describe the clinical case of a 65-year-old female patient with a diagnosis on hospital admittance of acute appendicitis and a intraoperative finding of diverticular disease of the small intestine, accompanied by complications such as intestinal perforation, bleeding and abdominal sepsis. This was surgically treated with intestinal resection and ileostomy and a subsequent re-intervention comprising perforation of the ileostomy and stomal remodeling. The patient remained hospitalized for approximately 1 month with antibiotics and local surgical wound healing, as well as changes in her diet with food supplements and metabolic control. She showed a favorable clinical evolution and was dismissed from the hospital to her home. We include here a discussion on trends in medical and surgical aspects as well as early handling or appropriate management to reduce the risk of fatal complications.

The purpose of this review is to summarize intraoperative surgical strategies available to decrease ischemia–reperfusion injury associated with liver resection and liver transplantation. We conducted a critical review of the literature evaluating the potential applications of hepatic ischemic preconditioning (IPC) for hepatic resection surgery and liver transplantation. In addition, we provide a basic bench-to-bedside summary of the liver physiology and cell signaling mechanisms that account for the protective effects seen with hepatic IPC.

Hepatic ischemia-reperfusion injury is commonplace in liver surgery, particularly in hepatic transplantation, hepatic resection, and trauma. The signaling events contributing to local hepatocellular damage are diverse and complex, and involve the interaction between hepatocytes, sinusoidal endothelial cells, Kupffer cells, as well as infiltrating neutrophils, macrophages, and platelets. Signaling mediators include cytokines, reactive oxygen and nitrogen species, calcium, complement, and several transcription factors. The purpose of this review article is to summarize the factors that contribute to the pathophysiology of hepatic ischemia-reperfusion injury.

Gallstone ileus is a rare cause of small bowel obstruction which usually presents in elderly female patients and which has been associated with high morbidity and mortality rates. We present the case of a 63-year-old man who presented at our institution with symptoms of bowel obstruction. Abdominal X-ray and exploratory laparotomy revealed a large gallstone in the terminal ileus.

To evaluate macro and microscopically the adhesions developed after using the anti-adherence compound sodium hyaluronate and carboxymethylcellulose (SH-CBMC) gel and to determine the volume of the adhesions using a stereological estimation.The study was experimental, random, comparative, and prospective. The subjects of the study were male Wistar rats divided in three groups (n = 10). Group I (control) included rats with no peritoneal injury. Group II rats had a 2 cm diameter injury created bilaterally in the parietal peritoneum at 3 cm from the abdominal midline with electrocautery coated with physiological solution. Group III rats were given the same injuries and coated with SH-CBMC gel. All groups were followed up postoperatively for 30 days, after which a laparotomy was performed to macroscopically determine the presence and type of adhesions. Experimental models were euthanized with anesthetic overdose and biopsies were taken for histopathological examination and stereological estimate of the volume of adhesions.Macroscopic adhesions were 20% less prevalent in Group III compared to Group II, which presented 40% more multiple and firm adhesions, unlike in Group III, in which they were unique and lax. There was a statistically significant decrease in the presence and number of adhesions in rats treated with SH-CBMC gel. Inflammatory infiltrate was significantly lower in rats treated with SH-CBMC gel, but there were no differences in connective tissue, fibrosis, and angiogenesis among groups. There was no statistical difference in the overall volume of adhesions among the treatment groups.SH-CBMC gel reduces macroscopic presence and number of adhesions and the severity of the inflammatory infiltrate.

Introduction Cholecystectomy is a common surgical procedure in which complications may occur, such as injury to the biliary tract, which are associated with high morbidity. The aim of this study was to demonstrate the efficacy of a polymer-based absorbable bioprosthesis with bone scaffold for the treatment of bile duct injury in an animal model. Materials and methods An absorbable bioprosthesis was used to replace the common bile duct in 15 pigs which were divided into 3 groups with different follow-ups at 1, 3 and 6 months. The animals were anesthetized at these time points and laboratory tests, Magnetic Resonance Cholangiopancreatogram [MRCP], Choledochoscopy using Spyglass and Endoscopic retrograde Cholangiopancreatogram [ERCP] were performed. After radiological evaluation was complete, the animals were euthanized and histological and immunohistochemical analyses were performed. Results Liver function tests at different time points demonstrated no significant changes. No mortality or postoperative complications were found in any of the experimental models. Imaging studies ([MRCP], [ERCP] and Choledochoscopy with SpyGlass ™ ) showed absence of stenosis or obstruction in all the experimental models. Discussion Histological and immunohistochemical staining (CK19 and MUC5+) revealed the presence of biliary epithelium with intramural biliary glands in all the experimental models. There was no stenosis or obstruction in the bile duct. Conclusions The bioprosthesis served as scaffolding for tissue regeneration. There was no postoperative complication at 6 months follow-up. This bioprosthesis could be used to replace the bile duct in cancer or bile duct injury. The bioprosthesis may allow different modeling depending on the type of bile duct injury.

Amebiasis is a worldwide health problem that mainly affects developing countries. Invasive amebiasis tends to develop complications, and among these, perforation of the colon, although infrequent (1.9–9.1%), is the most lethal. Surgical treatment in these cases should be carried out in a timely fashion prior to the presentation of systemic repercussions or death. In the present study, we analyzed a total of 122 cases of invasive amebiasis-associated colon perforation. We conducted a clinical, retrospective, and observational study and presented cases of colonic perforation observed over the past 30 years at the Medical-Surgical Emergency Service of the Mexico City-based Hospital General de Mexico OD during the 1970–1999 period. During this time, a total of 19,916 emergency abdominal surgeries were performed. One hundred twenty-two of these procedures corresponded to cases of colon perforation by ameba, which represents 0.6%; 80 patients were men (65.6%) and 42 were women (34.4%), with an average age of 48 years. Multiple colon perforation was 74%, with right colon the most affected (90.5%). Depending on the perforation’s extension and localization, right hemicolectomy with ileostomy were performed in 53 patients (43.45%), subtotal colectomy with ileostomy in 43 (35.25%), left hemicolectomy with transverse colostomy in 12 (9.83%), exteriorization of perforated left colon (stoma) in 13 (10.65%), and primary closure with exteriorization in one patient (0.8%). Post-operative complications were present in 48 patients (39.3%), and 20 cases were related with the creation of a stoma. Eighteen of these cases were due to persistent abdominal sepsis and ten due to toxic colon; the latter correspond solely to patients with initial nonresective treatment. General mortality was 40%, with 32% (17 of 53 cases) of mortality in those submitted to right hemicolestomy, 16.7% (two of 12) of left hemicolestomy, 44.2% (19 of 43) in those in whom a subtotal colectomy was performed, with 76.9% (ten of 13) patients with exteriorization of the perforated right colon, and with 100% (one of one patient) mortality with primary closure. Perforation is the most frequent surgical complication of invasive amebiasis of the colon, occurring principally in masculine gender and in the fourth decade of life. Resection and stoma creation is the procedure of choice that can resolve the septic focus from the first surgical procedure, depending on the general status of the patient. However, morbidity and mortality are high, and there is a tendency for these to be lower on comparing initial cases with those with recently conducted surgical procedures.

Total parenteral nutrition (TPN) has proven a tremendous advance in all disciplines in medicine but itself introduces a spectrum of possible complications related to both the parenteral nutritional solution as well as the technique of intravenous delivery. Our aim is to review the specific complications of TPN. This article presents a critical literature review of relevant topics in TPN-related complications—metabolic, infections, and nutrition related. Special emphasis focuses on complications of TPN arising from thrombosis or infectious sequelae related to the central venous catheterization and metabolic complications involving the kidneys, bones, liver, and biliary tract. Awareness and surveillance of TPN-related complications can prevent, potentially, some of these complications related to parenteral nutritional support.

Objective Fibrocollagen-covered polyester meshes can be used as possible substitutions for tracheal segments if they become integrated into the tissue without complications. The aim of this study was to assess a fibrocollagen-covered polyester prosthesis to be used as a substitution for a tracheal segment. Methods We performed a blind, randomized experimental assay. Adult Wistar rats were assigned to one of 2 groups. Prostheses were made by implanting polyester tubing in a group of animals to cover them with homologous collagen. They were implanted as substitutions of tracheal segments in the experimental group after creating a defect in the anterior wall of the trachea. Clinical, histomorphologic, and immunohistochemical assessments were made at 4 different time points. Results The experimental group presented some respiratory distress signs during the first 7 to 10 days, such as stertors, hissing, and low motor activity. After this initial period, the symptoms subsided progressively and disappeared at the end of the first month. These respiratory symptoms caused no mortality. Initially undifferentiated monolayer cells predominated on the implant's surface, but during the last 2 months, the proportion of epithelial and ciliated cells was similar to that seen in control animals. Types I, III, and V collagen fibers were identified around the mesh. The intraluminal area of the tracheas with prostheses and prosthesis thickness were larger during the 4 months of the experiment. The increase in thickness was due to angiogenesis without evidence of fibrosis or chronic inflammation. Conclusions Polyester-collagen prostheses used as substitutions of tracheal segments in rats enabled the proliferation of normal respiratory epithelium and maintained tracheal function without collapse, inflammatory reaction, or secondary stenosis.