Objective：To implant 80 mm-long artificial esophagi constructed of biomaterial in dogs, observe the perioperative survival rates and the incidence of postoperative complications, and study the mechanisms of postopera...Objective：To implant 80 mm-long artificial esophagi constructed of biomaterial in dogs, observe the perioperative survival rates and the incidence of postoperative complications, and study the mechanisms of postoperative healing. Methods： Specimens of the implanted esophagus, the ＂neo-esophagi＂, were taken for histopathologic study 1, 3, 6, 12, 24 months after operation. Results： The incidence of anastomotic leakage after the artificial esophagus implantation was 3.33%. The perioperative survival rate was 96.67%. The incidence of postoperative stenosis in the ＂neo-esophagi＂ was 81.48%; the stenoses were treated by expanding with esophagoscopy and implanting a stent. Epithelization of the mucosa in the ＂neo-esophagi＂ was completed in 3 to 6 months after surgery Structures such as submucosal muscle layers, mucous glands, nerve fibers, capillaries, etc. were regenerated after 12 months, and then reconstruction of the fibrous connective tissue layer was completed. Conclusion： Implanting a biomaterial artificial esophagus accomplishes safe reconstruction of defects in the esophagus. Advanced cellular structure of ＂neo-esophagus＂ can be regenerated after 1 year. Postoperative stenosis, which is related to hyperplasia and retraction of scar tissue, is still the most common complications which limiting the clinical application of the artificial esophagus.展开更多
A novel biological small-diameter vascular graft was evaluated in a canine model. 3 cm long segments with 4 mm I.D. were implanted end-to-end in the carotid position of 12 dogs for 6 months. Color Doppler sonography w...A novel biological small-diameter vascular graft was evaluated in a canine model. 3 cm long segments with 4 mm I.D. were implanted end-to-end in the carotid position of 12 dogs for 6 months. Color Doppler sonography was performed at the first week post-operation, and angiography was then administered to 9 grafts at 4th week, 12th week and 24th week respectively to monitor the graft pantency and blood flow characteristics. Vascular samples containing the grafts were collected at 1st week, 8th week, 12th week and 24th week after implantation. Morphological changes of the grafts were observed by optical and scanning electron microscopic (SEM) studies and compared with that of the original prosthesis and the normal host vessel. All grafts were patent throughout the experiment except one graft. Histopathology and SEM demonstrated both a nearly complete inner capsule of varied thickness lining the graft luminal surface and connective tissue adventitia formation at one-week post-operation. The neointima became confluent at 8 weeks and then compact but had no signs of hyperplasia up to 12 weeks; meanwhile on the neointimal surface newly grown endothelial-like cells were migrating from the stoma to the middle portion. The grafts also illustrated endothelialization in many “islands” in the mid-segment luminal surface of the grafts. In addition, the closer distance the cells towards the stoma were, the more morphological similarity the cells with the normal endothelial were. Taken together, the biological vascular graft remained patent for 24 weeks as a carotid prosthesis, characterized by the early and complete neointima formation plus endothelialization starting before 12 weeks post grafting. Therefore, the graft seems suitable for reconstruction of vascular lesions in dogs. Further studies may be carried out to extend the graft application for the clinical use.展开更多
基金Supported by the Science Foundation from Sci-Tech Office of Guangdong Province(A3020103)Science Foundation from Sci-Tech Bureau of Guangzhou City(2004Z3-E0551).
文摘Objective：To implant 80 mm-long artificial esophagi constructed of biomaterial in dogs, observe the perioperative survival rates and the incidence of postoperative complications, and study the mechanisms of postoperative healing. Methods： Specimens of the implanted esophagus, the ＂neo-esophagi＂, were taken for histopathologic study 1, 3, 6, 12, 24 months after operation. Results： The incidence of anastomotic leakage after the artificial esophagus implantation was 3.33%. The perioperative survival rate was 96.67%. The incidence of postoperative stenosis in the ＂neo-esophagi＂ was 81.48%; the stenoses were treated by expanding with esophagoscopy and implanting a stent. Epithelization of the mucosa in the ＂neo-esophagi＂ was completed in 3 to 6 months after surgery Structures such as submucosal muscle layers, mucous glands, nerve fibers, capillaries, etc. were regenerated after 12 months, and then reconstruction of the fibrous connective tissue layer was completed. Conclusion： Implanting a biomaterial artificial esophagus accomplishes safe reconstruction of defects in the esophagus. Advanced cellular structure of ＂neo-esophagus＂ can be regenerated after 1 year. Postoperative stenosis, which is related to hyperplasia and retraction of scar tissue, is still the most common complications which limiting the clinical application of the artificial esophagus.
基金Hi-tech Research and Development Program of ChinaGrant number:863 program#2006AA03Z441+1 种基金Guangdong Province Scienceand Technology Supporting ProgramGrant number:Project#2006B35830001
文摘A novel biological small-diameter vascular graft was evaluated in a canine model. 3 cm long segments with 4 mm I.D. were implanted end-to-end in the carotid position of 12 dogs for 6 months. Color Doppler sonography was performed at the first week post-operation, and angiography was then administered to 9 grafts at 4th week, 12th week and 24th week respectively to monitor the graft pantency and blood flow characteristics. Vascular samples containing the grafts were collected at 1st week, 8th week, 12th week and 24th week after implantation. Morphological changes of the grafts were observed by optical and scanning electron microscopic (SEM) studies and compared with that of the original prosthesis and the normal host vessel. All grafts were patent throughout the experiment except one graft. Histopathology and SEM demonstrated both a nearly complete inner capsule of varied thickness lining the graft luminal surface and connective tissue adventitia formation at one-week post-operation. The neointima became confluent at 8 weeks and then compact but had no signs of hyperplasia up to 12 weeks; meanwhile on the neointimal surface newly grown endothelial-like cells were migrating from the stoma to the middle portion. The grafts also illustrated endothelialization in many “islands” in the mid-segment luminal surface of the grafts. In addition, the closer distance the cells towards the stoma were, the more morphological similarity the cells with the normal endothelial were. Taken together, the biological vascular graft remained patent for 24 weeks as a carotid prosthesis, characterized by the early and complete neointima formation plus endothelialization starting before 12 weeks post grafting. Therefore, the graft seems suitable for reconstruction of vascular lesions in dogs. Further studies may be carried out to extend the graft application for the clinical use.
