[Impact of artificial esophagus slipped time upon the function formation of neoesophageal channel].
OBJECTIVE
To observe the impact of artificial esophagus slipped time upon the function formation of neoesophageal channel, explore the scope of secure control time and assess the treatment methods of neoesophageal stenosis.


METHODS
A total of 18 pigs in which artificial esophagus slipping at Month 1, 2, 3, 6 post-operation were observed with regards to complications, neoesophageal structures and functions and survival status of experimental animals.


RESULTS
Three pigs had a slip of artificial esophagus within a month post-operation and severe eating difficulties (Bown's Grade IV) because the neoesophagus had a severe narrowing (< 0.5 cm). All were dead shortly resulting from a failed treatment of esophageal dilation. Four pigs had a slip of artificial esophagus within 2 months post-operation. They all had dysphagia (Grade III-IV) as a result of moderate or severe neoesophageal stenosis (0.5 - 0.9 cm). Dysphagia was progressive. Repeated esophageal dilation was in vain. Three pigs were dead shortly and 1 pig achieved a long-term survival through a bare stent replacement therapy. Four pigs had a slip of artificial esophagus within 3 months post-operation. Dysphagia (Grade I-II) occurred as a result of mild or moderate neoesophageal stenosis (0.9 - 1.5 cm). Two pigs with moderate dysphagia achieved a long-term survival through a bare stent replacement therapy while another two were sacrificed. Seven had a slip of artificial esophagus at 3 months post-operation. The neoesophagus showed expansion and a relative narrowing (> 1.9 cm). Experimental animals had a mild difficulty in eating (Grade I), but it had an automatic relief. Experimental animals achieved a long-term survival and did not advance further.


CONCLUSIONS
Artificial esophagus (implant) stays in place for 2 - 3 months to form a functional esophageal channel. The longer an artificial esophagus is in place, a better channel of neoesophagus will form. Resetting a bare stent treatment of serious neoesophageal stenosis has significant therapeutic effects during this period. At 3 months post-operation, the slipping of artificial esophagus has little effects upon eating so that experimental animals may achieve a long-term survival.
Department of Thoracic Surgery, Second Affiliated Hospital of Guangzhou Medical College, Institute of Guangzhou Cardiovascular Diseases, Guangzhou, China. LiangJH@163.com
Jian-hui
JH
Liang
Xing
X
Zhou
Xian-liang
XL
Liang
D000818:Animals; D001187:Artificial Organs; D004947:Esophagus / Q000601:surgery*; D005260:Female; D020007:Implants, Experimental; D011474:Prosthesis Design; D013552:Swine; D014025:Titanium
D014025:Titanium