Abstract
The time and effort spent trying to devise an artificial esophagus have not yet resulted in success, and leakage and strictures at the anastomotic sites remain the most frequent complications. We developed an artificial esophagus with a bilayered structure made of porous collagen sponge (artificial dermis; AD), a latissimus dorsi muscle flap (LD), and split-thickness skin (STS). We investigated whether the use of AD prevented the contraction of grafted skin and its effects on the extensibility of the neoesophagus in rabbits. We experimented with two groups. In the AD group, AD was applied to the surface of the LD. Three weeks later, the STS was grafted. In the control group, the STS was grafted directly onto the LD. The sizes of the STS in both groups 3 weeks after the graft were, respectively, 56.6% ± 4.1% and 39.0% ± 10.2% of the initial surface area of the STS (P < 0.01). The roll made in the AD group had better extensibility than that in the control group. We replaced the cervical esophagus in 12 rabbits with the neoesophagus made from AD, STS, and LD. The longest survival period was 16 days. Esophagography did not reveal either anastomotic leakage or stenosis in any of the five rabbits in the experiments. These findings suggested that AD can thus be used to create a more suitable hybrid artificial esophagus.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Leininger BJ, Peacock H, Neville W (1970) Esophageal mucosal regeneration following experimental prosthetic replacement of the esophagus. Surgery 67:468–473
Takimoto Y, Okumura N, Nakamura T (1993) Long-term followup of the experimental replacement of the esophagus with a collagen-silicone composite tube. ASAIO J 39:736–739
Bircher E (1907) Ein beitrag zur plastischen bildung eines neuen oesophagus. Zentralbl Chir 34:1479–1482
Edgerton MT (1952) One-stage reconstruction of the cervical esophagus or trachea. Surgery 31:239–250
Baronofsky ID, Hilger J (1951) Fascia lata transplants for resected cervical esophagus. Surgery 30:355–360
Rob CG, Bateman GH (1949) Reconstruction of the trachea and cervical oesophagus. Preliminary report. Br J Surg 37: 202–205
Farrior RT (1964) Primary reconstruction of cervical esophagus, use of the free tracheal grafts. Arch Otolaryngol Head Neck Surg 79:258–268
Pate LIW, Sawyer LPN (1953) Failure of freeze-dried esophageal grafts. Am J Surg 86:152–153
Lyons AS, Beck AR, Lester JJ (1962) Esophageal replacement with prosthesis. Preliminary report of experimental studies. J Surg Res 2:110–113
Sheena KS, Ballentyne AL, Healley JE (1962) Replacement of the cervical esophagus with Marlex Mesh. Surgery 51:648–651
Natsume T, Ike O, Okada T (1993) Porous collagen sponge for esophageal replacement. J Biomed Mater Res 27:867–875
Suzuki S, Matsuda T, Maruguchi T (1995) Further applications of “bilayer artificial skin”. Br J Plast Surg 48:222–229
Shawney CP, Monga MB (1970) Wound contraction in rabbits and the effectiveness of skin grafts in preventing it. Br J Plast Surg 23:318–321
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Saito, M., Sakamoto, T., Fujimaki, M. et al. Experimental study of an artificial esophagus using a collagen sponge, a latissimus dorsi muscle flap, and split-thickness skin. Surg Today 30, 606–613 (2000). https://doi.org/10.1007/s005950070100
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s005950070100