[Experimental study on artificial esophagus created by a latissimus dorsi muscle flap with grafted jejunal mucosa]

An experimental study on artificial esophagus was performed in 38 mongrel dogs. Artificial esophagus was created by using a latissimus dorsi muscle, woven dacron vascular prosthesis and jejunal mucosa. A prepared latissimus dorsi muscle flap was cylindrically rolled, and jejunal mucosa with a woven dacron vascular prosthesis as a stent was inserted into this muscle canal. Although, all of these mucosal grafts fell down to necrosis with severe bacterial infections. The main cause of this failure was poor blood supply to the grafted mucosa via the muscle flap. For this reason, artificial granulation tissue with newly developed abundant vessels was made on the muscle surface by means of an insertion of the woven dacron vascular prosthesis into the muscle canal. Two weeks later, inner surface of the muscle canal had good granulations with a rich blood flow. And then the free jejunal mucosa of 10cm in length was grafted into this canal. Consequently, all grafted mucosa were well survived and had normal mucosal structures in the whole transplanted length. Based on these results, a latissimus dorsi muscle flap with the mucosal graft is possible to use as an artificial esophagus.