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

自体粘膜细胞混合型人工食管再生食管的实验研究

基本信息

批准号：
03454320
负责人：
SHIMIZU Yasuhiko
金额：
$ 4.16万
依托单位：
KYOTO UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1991
资助国家：
日本
起止时间：
1991 至 1992
项目状态：
已结题

项目摘要

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.

我们研究了一种由硅胶管覆盖胶原海绵制成的新型人工食道。其目的是用宿主组织取代胶原海绵，导致新的食道再生。在本研究的前一部分，为了缩短新食道上皮化的时间，我们在替换时将颊粘膜细胞注射到人工食道的胶原层中，并在早期成功地诱导了新食道的形成和上皮化。但慢性期的狭窄仍然存在。我们认为这种狭窄主要是由于黏膜下组织再生不良所致，而不是由于再上皮化过大所致。因此，我们根据支架脱出的时间来检查狭窄程度。在支架放置超过4周的情况下，没有发生狭窄，因此在手术后体重没有减轻的情况下，仍然可以进行口服喂养。在这个序列中，我们得出的结论是，吻合口狭窄的发生取决于支架放置的时间，当被我们的人工食道替代的部分被支架放置至少4周时，狭窄不会发展。显微镜下，长期存活者的新食道中发现了肌肉组织和食管腺。鉴于这一结果，我们现在正试图用我们的人造食道取代较长的食道，以阐明肌肉和腺体再生的机制。