The Possibility of Replacing Esophagus by a Tracheal Segment

Introduction & The replacement of segments of esophagus damaged by a tumor or other diseases is usually difficult requiring complex surgical procedures such as replacement of the involved area with stomach, colon, small bowel or composite tissue flaps. In esophageal lesions, this problem is more complicated; whereas, the resection of the segments of trachea and anastomosis of the two ends is a simple and practical procedure with low complications. In this experimental study we resected a piece of cervical esophagus and replaced it with a segment of trachea to find a simple solution for patients suffering from esophageal lesions. In 20-30 kg mature adult dogs, 5 cm of trachea was resected while preserving its attachments to the surrounding fibroareolar tissues. Then, 5 cm of esophagus was resected and replaced with the prepared segment of trachea. End to end tracheal anastomosis performed by a combination of interrupted and running vicryle sutures and anastomosis of esophageal ends to the tracheal segment was performed by running nylon sutures. No complication occurred during surgery. Both swallowing function and voice were normal in all three dogs after the operation. Oral diet started the day after operation. No sign of aspiration was seen in clinical and radiographic examinations. On autopsy examination, anastomoses were patent without being narrowed or having abnormal muscosal changes. The replacement of segment of esophagus with an autogenous tracheal segment is a practical procedure with low complications and can probabely be used for the treatment of esophageal lesions in human begings.