Esophageal reconstruction: Combined application of muscle tissue flap and inner chitosan tube stent in rabbits

Abstract

Abstract. BACKGROUND:Esophageal reconstruction is the key issue in esophageal surgery. However, currently there is no satisfied technique to repair esophagus after surgery. OBJECTIVE: To combine an inner chitosan stent and a muscle tissue with vascular pedicle to repair the esophageal defect in cervical segment. METHODS: Esophageal defect was repaired using the combination of a muscle tissue flap and a chitosan tube stent in experimental group while only muscle tissue flap was utilized in controls for comparison. One animal in each group was sacrificed at week 3, 6 and 9 after operation respectively to exam the healing status. Barium X-ray was used to evaluate the esophageal status in 12 weeks. RESULTS: Histology showed the inflammatory response in 3 weeks after surgery, the chitosan stent was partially absorbed in 6 weeks, and there was no obvious fibrotic proliferation in experimental group; while the fibrotic proliferation and esophageal stenosis were obvious in controls, the chitosan stent was completely absorbed in 9 weeks, and squamous epidermis cells were observed. Twelve weeks later, the barium swallow went smoothly through the esophagus with noticeable peristalsis in the experimental group; esophageal stenosis without peristalsis was observed in controls. CONCLUSION: The combination of chitosan stent and muscle tissue flap is feasible to reconstruct a partial defect in esophagus.