| Esophageal reconstruction is required to rebuild the continuity of digestive tract after esophageal incision. However, there are many early and late stage complications after reconstructive operation with stomach, colon or other abdominal apparatus as esophageal substitutes. So, scholars had great efforts to find various esophageal substitutes. The aim of our experiment is to use a new type esophageal prosthesis , which is pulmonary tissue with vascular pedicle ( PTVP) , to assume the feasibility and to resolve some problems. It is necessary to do it for the further study.Materials and MethodsI Materials(I) AnimalsTwelve adult mongrel dogs weighing 11 - 18kg, no matter male or female, were used for the study ( provided by Animal Lab of the Second Affiliated Hospital of China Medical University).(II) Drugssodium thiopental, 20% intralipid, penicillin, cefuroxime, van-corny cin, and so on.(III) Appliancesoperating table, anesthesia machine, thoracic operating appliances , X - ray machine, light microscope, transmission electron microscope (TEM).II Methods(I)Operative procedures:Dogs were anesthetized by sodium thiopental 30mg/kg injection in the cavity of peritoneum, and intubated immediately. A right thora-cotomy was performed through the fourth intercostals space. Middle lo-bar bronchus of right lung was ligated and incised, so the PTVP was made. A 4 cm long and 1/2 - 2/3 circled esophageal wall, full -thickness defect was created. The defect was patched by PTVP, and the anastomoses were completed with two layers suture between the prosthesis and the esophageal wall. A gastrostomy was performed. An infusion tube was inserted into the left femoral vein.(II) Postoperative procedures1. Antibiotics were used intravenously or subcutaneously for seven days2. Oral feeding was not given in first seven days after operation. The dogs were fed by infusion tube, 330kj/kg and 60 ml water/kg per day. Three days later, nutritious milk was given by gastrostogavage. In next seven days liquid food was started orally, and semisolid food gradually.3. One dog was put to death at each of the following times: 2, 4, 4, 6, 6, 8, 10 weeks after the reconstructive operation. Esophagogra-phy was performed at 8 weeks after the operation. The contrast medium was injected through the endoesophageal tube with the dog under general anesthesia. Endoscopic examination was performed in dogs survived 10 weeks after the operation. Neoesophageal tissue formationwas examined by microscopy and TEM.ResultI Seven dogs were put to death at planned times: 2, 4, 4, 6, 6, 8, 10 weeks after the reconstructive operation. One dog is still a-live without problems for more than 5 months. One dog survived 38 days and died of chronic pyothorax. The other three dogs died of anas-tomotic leak in 5 - 7 days after operation.H The living dogs could be fed orally at seventh day after operation. There was one similar behavior at early feeding stage, which was vomiting and re - ingestion of the vomitus, which was observed in all living dogs. However, the frequency of such behavior decreased gradually and disappeared until 3 months or so after operation. The body weight decreased in early stage and recovered to the preoperative body weight until 3 months or so.HI Histological examination: At 2 weeks after operation: Macro-scopically, the internal surface of the defect was covered with filthy membranous substance. The free edge of the esophageal defect was firmly linked with PTVP. Microscopically, the esophageal defect was replaced by collagen layer and inflammatory exudation. Beneath it fibrous tissue and granulation tissue were found. A little epithelization was observed at free edge of the esophageal defect, which was 1-2 layers of stratified squamous epithelium cells. At 4 - 6 weeks after operation : Macroscopically, the internal surface of the defect was completely or incompletely covered with a layer of white polished mucosa. A little stenosis was found in the middle portion of the defect. Microscopical...
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