Intrathoracic esophageal replacement by in situ tissue-engineered esophagus
Intrathoracic esophageal replacement by in situ tissue-engineered esophagus
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DOI：
10.1016/j.jtcvs.2008.05.027
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发表时间：
2008-10-01
影响因子：
6
通讯作者：
Hagiwara, Akeo
中科院分区：
文献类型：
--
作者：
Nakase, Yuen;Nakamura, Tatsuo;Hagiwara, Akeo
目的：本研究的目的是评估原位组织工程食管在犬模型后，实验切除和替换全环缺损的胸内esophago.Methods：两种类型的支架制作。KF（+）组（n = 6），将人羊膜上培养的口腔角质形成细胞和成纤维细胞铺在含有平滑肌组织的聚乙醇酸毡上，然后绕管滚动。KF（-）组（n=6），采用相同的程序，但省略角质形成细胞和成纤维细胞。将两种支架包裹在网膜中并植入腹部。在KF（1）组中，在植入后3周，支架发育成具有分层鳞状细胞的分化良好的管腔的管，其周围是厚的平滑肌样组织（原位组织工程食管）。结果：KF（2）组食管置换术后出现狭窄，2 ~ 3周内几乎完全梗阻;相反，在KF（1）组中，原位组织工程食管表现出良好的扩张性，并且狗在420天内没有进食问题。尽管原位组织工程食管本身没有蠕动活动，但食管蠕动将食物转移到胃。结论：原位组织工程食管可成功替代胸内食管，为食管疾病的治疗提供了一种新的手术方法。
Objective: This study aimed to evaluate in situ tissue- engineered esophagus in a canine model after experimental resection and replacement of a full circumferential defect of the intrathoracic esophagus.Methods: Two types of scaffolding were fabricated. In the KF(+) group (n = 6), oral keratinocytes and fibroblasts cultured on human amniotic membrane were sheeted on polyglycolic acid felt with smooth muscle tissue and were then rolled around tubes. In the KF(-) group (n=6), the same procedure was followed, but the keratinocytes and fibroblasts were omitted. Both scaffolds were wrapped in omentum and implanted in the abdomen. In the KF(1) group, at 3 weeks after implantation, the scaffold developed into a tube with a well- differentiated lumen of stratified squamous cells surrounded by a thick smooth muscle- like tissue (in situ tissue- engineered esophagus). A part of the esophagus was resected and replaced by the graft in the same dogs.Results: In the KF(2) group, strictures developed after esophageal replacement, with almost complete obstruction within 2 to 3 weeks. In contrast, in the KF(1) group, the in situ tissue- engineered esophagus showed good distensibility and the dogs remained without feeding problems through 420 days. Esophageal peristalsis transferred food to the stomach, despite the absence of peristaltic activity in the in situ tissue- engineered esophagus itself. The thickness of the squamous epithelial layer and the smooth muscle layer of the in situ tissue- engineered esophagus were similar to that of the adjacent native esophagus.Conclusion: The in situ tissue- engineered esophagus can successfully replace the intrathoracic esophagus, and this procedure may offer a promising surgical approach to esophageal diseases.