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《Chinese Journal of Tissue Engineering Research》 2013-51
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Chitosan tubular stent combined with muscle flaps for repair of partial defects of the cervical esophagus

Chen Gang;Liu Han-yun;Wang Bin;Zhang Zi-zheng;Wang Zhi-ping;Department of Thoracic Surgery,Meizhou People's Hospital of Sun Yat-sen University;Department of Cardiology,Taizhou Hospital of Zhejiang Province,Wenzhou Medical University;Department of Cardiothoracic Surgery,First Affiliated Hospital of Sun Yat-sen University;  
BACKGROUND:Over the years,muscle,skin,skeletal muscle flaps and luminal tissues,such as stomach and intestines,are used as an artificial esophagus to repair esophagus defects,but the results are not good.OBJECTIVE:To investigate the feasibility of chitosan tube stent combined with muscle flaps to repair partial defects of the cervical esophagus.METHODS:Thirty white rabbits were used to make animal models of partial cervical esophageal defects,and randomly divided into experimental group(n=20) and control group(n=10).Esophagus defect in rabbits of experimental group was repaired using autologous muscle flap with a chitosan tube stent,and esophagus defect in the control group was repaired only with muscle flap.Gross and histological appearance was observed at weeks 2,4 and 8 after operation,and barium sulphate X-ray screen was performed at week 10 after operation.RESULTS AND CONCLUSION:After 2 weeks,muscle tissue structure,cell swelling,and inflammatory cell infiltration could be seen in the experiment and control groups,exhibiting an acute inflammatory reaction.After 4 weeks,the experimental group showed clear muscle flaps,reduced inflammatory reaction,and no obvious fibrosis;while in the control group,muscle tissue could be seen at defect site,with growth of fibrous tissue cells and a few of inflammatory cells.After 8 weeks,in the experimental group,squamous metaplasia could be seen on the gross surface of the muscle flaps,esophageal mucosa could be seen,accompanied by chronic inflammatory reaction under the mucosas that had a clear abate than that at 4 weeks after implantation;in the control group,chronic inflammatory reaction could be found,accompanied by clear fibrosis but no squamous metaplasia and mucosal regeneration.Barium sulphate examination found that the esophagus was smooth with a slight motility in the experimental group,but there was a part of stricture in the esophagus without motility.These findings suggest that the chitosan tube stent combined with muscle flaps could better repair partial defects of the cervical esophagus.
【Fund】: 广东省卫生厅医学科研基金资助(A2013799)~~
【CateGory Index】: R318.08
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