Three-layered scaffolds for artificial esophagus using poly(ɛ-caprolactone) nanofibers and silk fibroin: An...

The purpose of this study was to determine the feasibility of an artificial esophagus using a three-layered poly(ε-caprolactone) (PCL)-silk fibroin (SF) scaffold in a rat model. The artificial esophagus was a three-layered, hybrid-type prosthesis composed of an outer and inner layer of PCL with a middle layer of SF. After depositing the inner layer of the PCL scaffold by electrospinning, the lyophilized middle SF layer was created. The outer layer of PCL was produced following the same procedure used to make the inner PCL layer. Eleven rats were anesthetized using inhaled anesthesia. Circumferential defects of the cervical esophagus (n=11) were created and reconstructed. Groups of rats were sacrificed after the 1st and 2nd weeks. Three rats died of an esophageal fistula and wound infection. No gross evidence of a fistula, perforation, abscess formation, seroma accumulation, or surrounding soft-tissue necrosis was observed in the other rats sacrificed after the 1st and 2nd weeks. The artificial esophagus constructs produced complete healing of the circumferential defects by the 2nd week. The composition of the three-layered artificial esophagus was confirmed histologically to have an outer and inner layer of PCL and a middle layer of SF. The fusion of the PCL-SF scaffold and the regenerative tissue remained intact. Our study proposes a more practical experimental model for studying a three-layered PCL-SF scaffold in the esophagus. However, further studies on circumferential defect reconstruction in a rat model are still required.