Experimental replacement of the thoracic esophagus with a bioabsorbable collagen sponge scaffold supported by a silicone stent in dogs.
We manufactured an esophageal prosthesis made of a collagen sponge supported by an inner silicone tube. The collagen was derived from porcine skin and was crosslinked by dehydrothermal treatment. We implanted our prosthesis in nine dogs after resecting a 5 cm length of the thoracic esophagus. Intravenous hyperalimentation was performed for 4 weeks after the surgery. After 29 days, the inner silicone tube was removed endoscopically and oral feeding was restarted immediately. All nine dogs survived more than 1 month, and three of the nine dogs survived for more than 1 year. Endoscopically, the luminal surface of the regenerated esophagus was covered with a lustrous, smooth mucosa, but stenosis was observed in the midregion of the regenerated esophagus. Microscopically, no foreign material remained at the reconstructed site 1 month after surgery; the collagen sponge was absorbed and replaced by host tissue. Complete epithelization was observed within 3 months. Regeneration of the lamina muscularis mucosae, esophageal glands, and skeletal muscle were observed near the anastomoses. Our artificial esophagus holds promise for esophageal reconstruction in a clinical setting, even in the thorax.
Yamamoto
Y
Y
Institute for Frontier Medical Sciences, Department of Bioartificial Organs, Kyoto University, Japan.
Nakamura
T
T
Shimizu
Y
Y
Takimoto
Y
Y
Matsumoto
K
K
Kiyotani
T
T
Yu
L
L
Ueda
H
H
Sekine
T
T
Tamura
N
N
D000818:Animals; D001187:Artificial Organs; D003094:Collagen; D004285:Dogs; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006439:Hemodynamics; D012828:Silicones; D015607:Stents; D013552:Swine; D013909:Thorax
D012828:Silicones; D003094:Collagen