Experimental Study for Development of Artificial Esophagus

人工食道在临床应用中存在吻合口不全、狭窄等问题。为了解决这些问题，开发实用的人工食道，我们寻找适合人体的假体材料，并对假体的快速上皮化进行了研究。作为假体材料，我们在狗身上尝试了可吸收缝合线(聚乙二酸管)和不锈钢网状管。这些东西被大网膜包裹并埋在皮下组织中。四周后，留置管内可见管状肉芽组织。用背阔肌肌瓣包裹时也可形成同样的肉芽组织。我们特意将皮瓣的边缘插入假体中。从这个插入的皮肤边缘，鳞状细胞上皮扩张。然而，这种上皮化缓慢地扩散到整个肉芽组织。因此，为了控制感染，我们正在尝试细胞种植和应用EGF(表皮生长因子)来快速上皮化假体内的肉芽。

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.