Comparative experimental study of esophageal wall regeneration after prosthetic replacement

This study compares three prosthetic materials for potential use in patchin g and bridging congenital and acquired esophageal defects. The study was di vided into two parts. in the first part, fulll-thickness, 6-cm(2) cervical esophageal defects were induced in three groups of young mongrel dogs and w ere replaced with patches of lyophilized dura mater (Lyodura), polyethylene terephthalate (Dacron), or expanded polytetrafluoroethylene (PTFE). The do gs in the Lyodura subgroup were scheduled to be sacrificed after 1, 2, 4, 8 , and 12 weeks and the dogs in the PTFE and Dacron subgroups were sacrifice d after 1, 2, 3, 4, 6, and 7 months. The patched esophagus was removed for gross and microscopic examination, In the second part of the study a segmen t of the Esophagus was excised in another three groups of dogs and replaced with 3 x 2 cm tubes of Lyodura, Dacron, or PTFE. Here the follow-up was pr olonged and included radiological, endoscopic, and histological assessment. The dogs of each subgroup were scheduled to be sacrificed after 6, 8, and 12 months. Results indicated that lyophilized dura mater covered and neoepi thelialized the patched area within the shortest period of time without for eign body reaction and with only slight collagen deposit, resulting in a du ctile repaired esophageal wall. Therefore, its use may be considered for re placement of partial esophageal defects. For complete circumferential defec ts, the present study and our review of: the literature showed that there i s as yet no ideal prosthetic material that promotes good incorporation but is not prone to stenosis. Further studies in this area are required. (C) 19 99 John Wiley & Sons, Inc.