Experimental Study on A Hybrid Type Artificial Esophagus Used Autologus Mucosa Cells Intending Neoesophageal Regenenation

我们研究了一种新型的人工食管，它由硅胶管和胶原海绵组成。目的是胶原海绵将被宿主组织取代，导致新食管再生。在本研究的前一部分中，为了缩短新食管上皮化的时间，我们在替代时将颊粘膜细胞注射到人工食管的胶原层中，并且我们成功地在早期诱导新食管形成和上皮化。然而，慢性期的狭窄仍然存在。我们认为这种狭窄主要是由于粘膜下组织再生不良，而不是上皮再生的大部分。因此，我们根据支架脱落的时间检查狭窄程度。在支架保持在适当位置超过4周的情况下，没有发生狭窄，因此手术后仍然可以口服喂养而没有体重减轻。在这个序列中，我们得出结论，吻合后狭窄的发生取决于支架植入时间，并且当被我们的人工食管替代的部分支架植入至少4周时，狭窄不会发展。显微镜下，肌肉组织和食管腺在长期生存的新生食管中被确定。鉴于这一结果，我们现在正试图用我们的人工食管代替较长的食管，以阐明肌肉和腺体再生的机制。

We have studied a new type of artificial esophagus made from a silicone tube covered with collagen sponge. The intention was that the collagen sponge would be replaced by host tissue, leading to neoesophagus regeneration. In the previous part of this study, in an attempt to shorten the time of neoesophageal epithelization, we injected buccal mucosal cells into the collagen layer of the artificial esophagus at the time of substitution, and we succeeded in inducing neoesophagus formation and epithelization at an early stage. However the stenosis in the chronic stage still remained. We considered that this stenosis was caused mainly by poor regeneration of submucosal tissue, rather than the grand of reepithelization. Therefore we examined the grade of stenosis according to the time when the stent became disloged. In cases where the stents remained in place for more 4 weeks, stenosis did not occur, and consequently oral feeding remained possible without weight loss after surgery. In this sequence we concluded that the occurrence of stenosis after anastomosis depended on the stenting time, and that stenosis did not develop when the part replaced by our artificial esophagus was stented for at least 4 weeks. Microscopically, the muscle tissue and the esophageal glands were identified in the neoesophagus of the long-term survivors. In the view of this results, we are now attempting to replace the longer esophagus with our artificial esophagus to elucidate the mechanism of regeneration of muscle and gland.