J.Jpn. Surg. Soc.. 56(8): 1043-1069, 1955

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EXPERlMENTAL AND CLINICAL STUDIES ON THE ESOPHAGEAL TRANSPLANTATION USING CHIEFLY HETERO-AORTIC GRAFTS PRESERVED IN ALCHOHOL

Esphageal transplantation, as the simplest and physioIogical procrdure for the treatment of the esophageal stenosis is studied experimentally and clinially, and the following results were obtained.
1) Materials :
The materials for transplantation were aortas from horses, oxen and pigs in most cases but sometimes tracheas preserved in alchohol. Intestines either fresh or preserved in 70 per cent alchohol solution, the O.M.S. tube as an artificial material from the intestinal tracts, as weII as polyethylene tube were also used. lt was demonstrated that the materials preserved in alchohol among other materials showed the best results for the esophageal transplantation.
2) Posttransplantation stenosis of the esophagus and it's preventive measures:
A large number of dogs died on account of the secondary weakness due to the postoperative stenosis occurring witnin two or three weeks after operation. For the preventive measures of the postoperative stenosis, the insertion of polyethylene tube into the graft, as a splint, was exceedingly effective. This procedure was successfully used in our clinic.
3) Fate of the grafts:
The replacement phenomenon by the granulation from the surrounding tissues was observed on the transplanted area within 4 weeks after operation, the organization in the area was completed and then the new esophagus was formed. The characteristics of hetero aortic grafts as materials for transplantation area :
a) Elastic fibers of the aorta may play an important roIe of reinforcing without being absorbed for relalively Iong period.
b) The epithelization appears early as compared with the use of poIyethylene only.
4) Clinical experiments:
The author attempted to apply this esophageaI transplantation described above in the patients suffering from the cancer of cervical and thoracic portions of the oesophagus. It is evident that the clinical purpose of transplantations were accomplished sufficiently, although these patients died of the regional recurrences, with metastasis within 3-6 months postoperatively.
(authors' abstract)

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