Intrathoracic esophageal replacement with a collagen sponge-silicone double layer tube: Evaluation of omental-pedicle wrapping and prolonged placement of an inner stent

In a previous study, we replaced a 5 cm gap created in the canine intrathor acic esophagus with an artificial esophagus. However, although newly formed esophageal tissue subsequently bridged the gap, mild stenosis occurred, an d this seemed-to be caused by inadequate regeneration of the skeletal muscl e. In the present study, we evaluated whether omental pedicle wrapping (OMP x) of the prosthesis could promote tissue regeneration and whether prolonge d retention of the silicone tube within the prosthesis could prevent stenos is. A gap was created in 14 dogs, and the defect was repaired by our prosth esis. OMPx was performed in 5 of the 14 dogs (OMPx group) but not in the re st (control group). The silicone tube was retained for 4 weeks in the contr ol group and for 8 weeks in the OMPx group. All of the dogs in the control group survived for more than 3 months, except for those that were killed. F our dogs in the OMPx group died within:3 months, one caused by perforation at 7 months. Only the thin epithelial and submucosal layer regenerated in t he OMPx group. OMPx is not effective for promoting tissue regeneration, and prolonged retention of the silicone tube interrupts epithelial regeneratio n.