Experimental replacement of the thoracic esophagus with a bioabsorbable collagen sponge scaffold supported by a silicone stent in dogs

We manufactured an esophageal prosthesis made of a collagen sponge supporte d by an inner silicone tube. The collagen was derived from porcine skin and was crosslinked by dehydrothermal treatment. We implanted our prosthesis i n nine dogs after resecting a 5 cm length of the thoracic esophagus. Intrav enous hyperalimentation was performed for 4 weeks after the surgery. After 29 days, the inner silicone tube was removed endoscopically and oral feedin g was restarted immediately. All nine dogs survived more than 1 month, and three of the nine dogs survived for more than 1 year. Endoscopically, the l uminal surface of the regenerated esophagus was covered with a lustrous, sm ooth mucosa, but stenosis was observed in the midregion of the regenerated esophagus. Microscopically, no foreign material remained at the reconstruct ed site 1 month after surgery; the collagen sponge was absorbed and replace d by host tissue. Complete epithelization was observed within 3 months. Reg eneration of the lamina muscularis mucosae, esophageal glands, and skeletal muscle were observed near the anastomoses. Our artificial esophagus holds promise for esophageal reconstruction in a clinical setting, even in the th orax.