[Ultrastructural changes in tissues in postburn cicatricial esophageal stenosis during bougienage and prolonged...

The ultrastructure of tissues in postburn esophageal strictures was studied in 24 patients varying in ages from 23 to 70 years with the postburn period ranging from 1 1/2 months to 36 years. Biopsy samples for the study were collected during fibroesophagoscopies before treatment, after bougienage and longterm intubation with the Tkachenko tube. Before treatment, pathologically altered granulation tissue forming the surface of ulcerated esophageal strictures was found to contain such mature forms of fibroblasts as collagenoblasts with moderate collagen-producing activity, myofibroblasts, and fibrocytes. Mechanical effects of bougienage and intubation of the esophagus stimulated formation of young granulation tissue in the area of ulcerated strictures, intubation of the strictures stimulating both biosynthesis and catabolism of collagen. Mature forms of fibroblasts of young granulation tissue formed in bougienage were represented by collagenoblasts with intensive collagen-producing activity, myofibroblasts, fibrocytes, and after long-term esophageal intubation also by fibroclasts.