可降解复合人工食管重建犬颈段食管的实验研究(英文)

Replacing dog cervical esophagus with polyurethane stent covered with collagen-chitosan sponge

目的 :研究聚氨酯胶原蛋白壳聚糖复合人工食管重建犬颈段食管的可行性。方法 :将医用聚氨酯管表面覆盖海绵状胶原蛋白壳聚糖膜制成的人工食管 ,通过手术替换 15只犬颈段 5 cm食管缺损 ,术后给予营养支持 ,禁食 2周或 4周后通过内镜取出聚氨酯内管进行观察。结果 :禁食 2周后取出聚氨酯内管的 5只实验犬 ,新生食管上皮再生不完全 ,术后 1个月内均出现进行性狭窄无法吞咽 ;禁食 4周后取出聚氨酯内管的 10只实验犬 ,术后 1个月新生食管完全上皮化 ,术后 3个月 ,黏膜全层结构完整再生 ,术后 6个月食管肌层部分再生。结论 :聚氨酯胶原蛋白壳聚糖复合人工食管重建犬颈段食管具有可行性 ,通过聚氨酯内管提供临时通道 ,海绵状胶原蛋白壳聚糖膜提供适宜细胞爬行再生的三维多孔支架并维持足够长的降解时间 ,能促使自身食管完全再生。

Objective: To replace esophageal defects with artificially composed biodegradable materials and non biodegradable materials. Methods: A two layered tube consisting of a collagen chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defects in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of esophageal epithelia was observed in 5 dogs at week 2, and progressing constriction occurred and the dogs became unable to swallow within 1 month. In the 10 dogs that the polyurethane stent was removed at week 4, regenerated esophageal tissue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, including mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis in reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen chitosan sponge provides a three dimensional structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.