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道，由硅胶管覆盖胶原蛋白海绵制成。目的是将胶原海绵替换为宿主组织，导致新食管再生。在本研究前期，为了缩短食管新上皮形成的时间，我们在置换时将口腔黏膜细胞注射到人工食管的胶原层中，成功地在早期诱导了食管新上皮的形成。但慢性期狭窄仍存在。我们认为这种狭窄主要是由粘膜下组织再生不良引起的，而不是再上皮化的巨大。因此我们根据支架脱离的时间来判断狭窄程度。在支架放置超过4周的病例中，没有发生狭窄，因此可以在术后口服喂养而不会减轻体重。在这个序列中，我们得出吻合后狭窄的发生与支架置入时间有关，并且当我们的人工食管替代部分支架置入至少4周后没有发生狭窄。显微镜下，在长期幸存者的新食道中发现了肌肉组织和食道腺。鉴于这一结果，我们现在正尝试用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.