Experimental Study for Development of Artificial Esophagus

人工食管临床应用中存在的问题是吻合口不全和狭窄。为了解决这些问题，研制实用的人工食管，我们寻找适合人体的人工食管材料，并对人工食管的快速上皮化进行了研究，在狗身上试用了可吸收缝合线（聚葡萄糖酸）制成的管和不锈钢网状管作为人工食管的材料。这些被网膜包裹并埋在皮下组织中。4周后，在留置管内发现管形肉芽。M肌瓣也可形成类似肉芽。背阔肌用于包裹。我们有意将皮瓣边缘插入假体中。从这个插入的皮肤边缘，鳞状上皮细胞已经扩张。然而，这种上皮化在肉芽组织上扩散缓慢。因此，控制感染，我们正在尝试细胞接种和应用EGF（表皮生长因子）的快速上皮化的肉芽内的假体。

The problems as for the clinical application of artificial esophagus are the anastomotic insufficiency and the stenosis. To resolve these points and to develope the practical artificial esophagus, we have searched for the materials for the prothesis which suit to the body, and have researched about the rapid epithelization onto the prothesis.As the materials of the prothesis, a tube made of absorbable suture thread (polyglycoric acid) and a stainless mesh tube were tried in dog. These were wrapped with omentum and buried in the subcutaneous tissue. Four weeks later, tube-formed granulation was found inside the indwelled tube. Same kind of granulation was also formed when the muscle flap of M. latissumus dorsi was used for wrapping. We have purposely inserted the edge of the skin flap into the prothesis-to be. From this inserted skin edge, squamous cell epithelium has expanded. However, this epithelization is slow to spread all over the granulation. So controlling infection, we are trying the cell-seeding and applying EGF (epidermal growth factor) for the rapid epithelization over the granulation inside the prothesis-to-be.