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Circumferential esophageal replacement using a tube-shaped tissue-engineered substitute: An experimental study in
Tigran Poghosyan1, Rony Sfeir2, Laurent Michaud3
1Cell Therapy Unit and CIC-BT, Saint-Louis Hospital, AP-HP, Paris, France; Department of Digestive and Endocrine Surgery, Saint-Louis Hospital, AP-HP, Paris, France; Inserm UMR 1160, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
Surgery
|March 23, 2015
Summary
Tissue-engineered esophageal replacement using a small intestinal submucosa matrix and temporary endoprosthesis support achieved nutritional autonomy and esophageal tissue remodeling in a porcine model.
Area of Science:
- Regenerative Medicine
- Tissue Engineering
- Gastroenterology
Background:
- Esophageal replacement for disease carries high risks.
- Tissue engineering offers a promising alternative.
- Developing functional esophageal substitutes is crucial.
Purpose of the Study:
- To evaluate a novel tissue-engineered esophageal substitute in a porcine model.
- To assess the efficacy of temporary endoprosthesis support.
- To determine the potential for esophageal tissue regeneration.
Main Methods:
- A 5-cm cervical esophagus segment was replaced with a tissue-engineered construct (small intestinal submucosa, skeletal myoblasts, amniotic membrane).
- The construct was pre-conditioned in the omentum for 2 weeks.
- Minipigs received the substitute with (Group A) or without (Group B) an endoprosthesis, or an endoprosthesis alone (Group C).
Main Results:
- High mortality (stenosis, extrusion) was observed in Groups B and C.
- Group A animals with temporary endoprosthesis achieved nutritional autonomy (>6 months follow-up).
- Histology showed esophageal tissue remodeling, including mature epithelium and muscle layers, after 9 months.
Conclusions:
- Circumferential esophageal replacement using a tissue-engineered substitute with temporary endoprosthesis support is feasible.
- This approach facilitates nutritional autonomy and promotes esophageal tissue regeneration.
- The temporary endoprosthesis is critical for initial healing and remodeling.
