METHOD FOR TWO-STAGE BIOENGINEERING RECONSTRUCTION OF UPPER DIGESTIVE TRACTS Russian patent published in 2020 - IPC A61B17/00 A61B17/24 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to oncology, and can be used for elimination of upper gastrointestinal defects, after removal of locally advanced tumors. Patient's epithelial tissue fragment produced by skin fragment biopsy of size 1×1 cm or oral mucosa size of 0.5×0.5 cm, the "in vitro" epithelial cells are isolated and cultivated to increase the cell mass. Then grown cells are transferred onto surface of biocompatible matrix and epithelial layer is formed. Autologous tissue equivalent of the mucous membrane thus created is implanted on the fascia of the greater pectoral muscle with a cellular layer upwards and fixed with a suture. Then muscle with tissue equivalent attached to it is isolated by film, wound is layer-by-layer closed, autologous tissue equivalent is left on muscle for 3–4 weeks. When mucous membrane is formed, delayed pharyngoplasty is performed: skin is incised in submammary region, skin-fat flaps are mobilized and dissolved, skin-fat flap is separated from greater pectoral muscle, film is removed and a muscle flap is formed with inclusion of a greater pectoral muscle on thoracoacromial vessels. Further, an incision is made surrounding the pharyngostomy on the border of the skin and mucosa; the edges of skin and mucosa are mobilized, and the formed prefabricated muscular flap is moved to the defect area. Further, the prefabricated fragment of the flap is sutured along the perimeter with the edges of the pharyngostomy mucosa by separate interrupted sutures. Muscular portion of the graft is additionally covered with sutures along the perimeter of pharyngostomy, soft tissues of the neck are restored with a muscular portion of the displaced flap and fixed with separate interrupted sutures. Neck wound is closed with leaving silicone drainage in underfoot space on the left side. Donor wound is closed in layers with leaving two silicone drains.

EFFECT: method provides restoration of defect of upper digestive tracts by using a prefabricated pectoral flap and recovery of epithelial lining and soft tissues.

1 cl, 1 ex, 5 dwg