Doctors Report on Success of Throat Reconstruction

Seven years after receiving metal stents, donated skin tissue, patient can swallow and eat normal food

By Robert Preidt

Friday, April 8, 2016

FRIDAY, April 8, 2016 (HealthDay News) -- An American man who underwent throat reconstruction seven years ago has no swallowing problems and can eat normal food, researchers report.

The man's severely damaged esophagus was reconstructed using commercially available metal stents and donated skin tissue. The stents -- approved in the United States to help esophageal cancer patients with a throat obstruction to swallow -- provided a scaffold for the tissue to grow on.

"This is a first in human operation and one that we undertook as a lifesaving measure once we had exhausted all other options available to us and the patient," said study author Dr. Kulwinder Dua. He is a professor in the division of gastroenterology and hepatology at the Medical College of Wisconsin, in Milwaukee.

The stents were removed four years ago, according to the study published April 8 in The Lancet.

"The approach we used is novel because we used commercially available products, which are already approved for use in the human body and hence didn't require complex tissue engineering," Dua explained in a journal news release.

Initially, the 24-year-old man had a life-threatening infection and couldn't swallow because of complications from an earlier car crash that left him partially paralyzed. The patient had a nearly 2-inch defect in his esophagus that was too large to repair with conventional surgery, despite several attempts.

Previously, the tissue regeneration technique had only been tested in animals. Further research in animals and people is needed to determine if this method can be repeated and used in similar cases, Dua said.

The medical team had planned to remove the stents 12 weeks after reconstruction surgery. But, the patient put off removal for three-and-a-half years due to fears about possible narrowing or leakage in his esophagus, according to the report.

One year after the stents were removed, endoscopy showed scarring and regeneration of all five layers of the esophagus wall. In addition, swallowing tests showed the esophagus muscles were functioning normally.

However, it's not known how long the regeneration process actually took because of the delay in stent removal, the researchers said.

SOURCE: The Lancet, news release, April 8, 2016

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