Imaging the Esophagus Oval and Circular Defect Reconstruction in Rats

Background and aim: Investigations of new possibilities for oesophagus replacement remains a challenge in digestive surgery. In the present study combined prosthesis with artificial and biological components proposed for oesophagus repair were tested by imaging techniques. Methods: Experiments were conducted on 30 laboratory rats which have survived a reconstructive surgery of the oesophagus. A bio prosthesis made of a degradable chitosan tubular scaffold and a vascularized flap of locally grown foetal oesophagus-stomach implant or of a local muscle were used for bridging oval or circular defects of the cervical oesophagus. Before the main reconstructive operation, ultra sound was used for evaluation of the growing foetal implant and its suitability for reinforcement of the prosthesis. Success of the reconstruction was assessed by both functional and morphological investigations. Roentgen imaging was used to assess the prosthesis presence and degradation delays, on the one hand, and the alimentary bolus transit through the reconstructed segment, on the other. After that, the animals were euthanized and histological examination of the reconstructed oesophagus was provided. Investigations were performed on the animals from 1week to 13 months after operation. Results: The results were encouraging: chitosan has shown adequate properties as a scaffold for both oval and circular defect bridging. After adjustments of operation techniques and follow up methods, the surgery could be considered as successful with a satisfying survival percent, a complete animal general condition recovery and the absence of leakage or significant stenosis. In vivo obtained images corresponded to the histologic findings of the reconstructed oesophagus wall restoration. Conclusion: Roentgen and ultra sound imaging (static and serial images) is possible and adequate to assess the presence of grown foetal oesophageal cyst necessary for the oesophagus defect repair, to verify the prosthesis evolution and the integrity or damage of the oesophagus after reconstructive surgery in the rat.