Experimental studies on an artificial esophagus for the purpose of neoesophageal epithelization using a collagen-coated silicone tube.

An artificial esophagus was fabricated from a collagen-coated silicone tube 5 cm long, with an inner diameter of 2.5 cm and a wall thickness of 1 mm. The outer surface was coated with dry collagen to 5 mm thickness. The bilayered prosthesis was anastomosed to the cervical esophagus of adult mongrel dogs that were fed only by intravenous hyperalimentation (IVH) with 80 cal/kg/day and 60 ml water/kg/day for 3 weeks after the operation. Once the dogs began to consume food orally, the artificial esophagus dropped spontaneously into the stomach and formation of the neoesophagus was complete. Macroscopically, the neoesophagus showed no evidence of leakage or inflammation and had a smooth internal surface, but it developed slight segmental narrowing. Microscopically, layers of stratified squamous epithelium covered the neoesophagus within 3 to 4 weeks. The most characteristic feature of the artificial esophagus was that the replacement prosthesis did not remain in the esophagus after healing. Esophageal epithelization extended into the collagen layer coating the silicone tube and a new esophageal lumen was regenerated, thereby decreasing the chance of infection and leakage. However, neoesophageal stenosis was observed when the silicone tube was removed.