Liang Jian-hui, Zhou Xing, Liang Xian-liang
Department of Thoracic Surgery, Second Affiliated Hospital of Guangzhou Medical College, Institute of Guangzhou Cardiovascular Diseases, Guangzhou, China.
Zhonghua Yi Xue Za Zhi. 2009 Sep 22;89(35):2509-12.
To observe the impact of artificial esophagus slipped time upon the function formation of neoesophageal channel, explore the scope of secure control time and assess the treatment methods of neoesophageal stenosis.
A total of 18 pigs in which artificial esophagus slipping at Month 1, 2, 3, 6 post-operation were observed with regards to complications, neoesophageal structures and functions and survival status of experimental animals.
Three pigs had a slip of artificial esophagus within a month post-operation and severe eating difficulties (Bown's Grade IV) because the neoesophagus had a severe narrowing (< 0.5 cm). All were dead shortly resulting from a failed treatment of esophageal dilation. Four pigs had a slip of artificial esophagus within 2 months post-operation. They all had dysphagia (Grade III-IV) as a result of moderate or severe neoesophageal stenosis (0.5 - 0.9 cm). Dysphagia was progressive. Repeated esophageal dilation was in vain. Three pigs were dead shortly and 1 pig achieved a long-term survival through a bare stent replacement therapy. Four pigs had a slip of artificial esophagus within 3 months post-operation. Dysphagia (Grade I-II) occurred as a result of mild or moderate neoesophageal stenosis (0.9 - 1.5 cm). Two pigs with moderate dysphagia achieved a long-term survival through a bare stent replacement therapy while another two were sacrificed. Seven had a slip of artificial esophagus at 3 months post-operation. The neoesophagus showed expansion and a relative narrowing (> 1.9 cm). Experimental animals had a mild difficulty in eating (Grade I), but it had an automatic relief. Experimental animals achieved a long-term survival and did not advance further.
Artificial esophagus (implant) stays in place for 2 - 3 months to form a functional esophageal channel. The longer an artificial esophagus is in place, a better channel of neoesophagus will form. Resetting a bare stent treatment of serious neoesophageal stenosis has significant therapeutic effects during this period. At 3 months post-operation, the slipping of artificial esophagus has little effects upon eating so that experimental animals may achieve a long-term survival.
观察人工食管滑脱时间对新食管通道功能形成的影响,探讨安全控制时间范围并评估新食管狭窄的治疗方法。
观察18只分别在术后1个月、2个月、3个月、6个月发生人工食管滑脱的猪的并发症、新食管结构与功能及实验动物的生存状况。
3只猪在术后1个月内发生人工食管滑脱,因新食管严重狭窄(<0.5 cm)出现严重进食困难(Bown氏IV级),均因食管扩张治疗失败短期内死亡。4只猪在术后2个月内发生人工食管滑脱,因中度或重度新食管狭窄(0.5 - 0.9 cm)均出现吞咽困难(III - IV级),吞咽困难呈进行性,反复食管扩张无效,3只猪短期内死亡,1只猪通过裸支架置换治疗长期存活。4只猪在术后3个月内发生人工食管滑脱,因轻度或中度新食管狭窄(0.9 - 1.5 cm)出现吞咽困难(I - II级),2只中度吞咽困难的猪通过裸支架置换治疗长期存活,另2只被处死。7只猪在术后3个月后发生人工食管滑脱,新食管呈扩张状态且有相对狭窄(>1.9 cm),实验动物进食轻度困难(I级),但可自行缓解,实验动物长期存活且未进一步发展。
人工食管(植入物)在位2 - 3个月可形成功能性食管通道,人工食管在位时间越长,新食管通道形成越好,在此期间对严重新食管狭窄行裸支架重置治疗有显著疗效。术后3个月人工食管滑脱对进食影响不大,实验动物可长期存活。