China's first autologous skin graft to cure esophageal damage
- Nov 06, 2018 -

Esophageal injury has always been a difficult point of treatment for digestive tract diseases. If the operation is improper, it is easy to cause esophageal stenosis and endanger the life of the patient. At the first special meeting of the Military Medical Digestive Diseases of the General Hospital of the Chinese People's Liberation Army held on November 2, Professor Ling Huqiang, Director of the Department of Gastroenterology, introduced a team's world's first technology. They collaborated with orthopedics to sew the patient's own skin into a cuff and use a metal stent to implant it into the esophagus for repair. The program has been published in the American Journal of Gastroenterology.

According to Zou Enqiang, esophageal injury is divided into two categories: damage and mucosal damage. Esophageal injury is difficult to repair, and esophageal stenosis is prone to occur after treatment.

Why is it narrow? "Because the skin of the esophagus is fragile and grows very slowly." Let Guenqiang take the example of esophageal cancer, the third highest incidence in China. "When the cancer tissue is peeled off, there is a vacancy in the esophageal skin, just like the carpet has been dug up, if not supplemented. The 'carpet', which directly sutures the wound, will appear narrow." The industry has tried to peel the skin into the esophagus from the patient's mouth, but the effect is not satisfactory. "Because the oral mucosa is limited, it is difficult to solve the problem of stenosis."

Lian Enqiang introduced a case of autologous skin graft to cure esophageal damage. The patient was a 62-year-old woman with high grade intraepithelial neoplasia of the esophageal mucosa. "We removed the grafted skin with an area of about 12 cm x 8 cm from the outside of the right thigh of the patient, sutured the suture into a cuff with an absorbable thread, and then sutured the sleeve-like graft to the fully coated metal. The bracket is made into a 'leather tube', and finally the 'skin tube' is fixed at the position of the esophageal wound." One week after the operation, the patient's transplanted skin piece grew well; after the stent was removed 4 weeks after surgery, the original was visible. Most of the grafts survived, and the color was not different from the normal esophageal mucosa; after 5 weeks, the grafted skin and the esophageal normal mucosa junction were more closely combined.

This study has included 10 patients with peri-circumflex lesions since 2017. Data show that the incidence of esophageal stricture is 37.5%, and the effective rate is 62.5%.