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Abstract
An artificial esophagus was made of silicone rubber (Phycon) tube covered with a Dacron
mesh. A segment of thoracic esophagus of 16 dogs was replaced with this graft using
three different types of anastomosis—overlayer end-to-end anastomosis with flanged
tube, two-layer end-to-end anastomosis with flanged tube, and monolayer end-to-end
anastomosis with no flange tube. Seven of 16 dogs (44%) survived more than 12 months
without complications, four of them surviving more than 6 years. In six of seven of
the prolonged survivors, extrusion of the graft was recognized in the 3 to 6 months
after operation. Esophageal stricture increased slightly up to 6 months after extrusion
of the graft, but it did not further advance until sacrifice. In these dogs, mucosal
regeneration of the neoesophagus was complete with muscle layers and mucous glands
in the submucosa recognized microscopically. Proximal esophagus from the replaced
portion was apparently dilatated more than that of the distal portion. There was no
definite difference between the anastomotic techniques with regard to complication
or prognosis. These results suggest that this artificial esophagus should be considered
as a possibility for clinical trials in the future.
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Article info
Publication history
Accepted:
May 14,
1982
Identification
Copyright
© 1983 Published by Elsevier Inc.
