Experimental Studies on an Artificial Esophagus for the Purpose of Neoesophageal Epithelization Using a Collagen-Coated Silicone Tube

Ike, Osamu; Shimizu, Yasuhiko; Okada, Toshikuni; Natsume, Tohru; Watanabe, Shōichi; Ikada, Yoshito; Hitomi, Shigemi

doi:10.1097/00002480-198907000-00015

Cited by 11 publications

(9 citation statements)

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“…Once in vivo regeneration of the esophageal tissue is complete, the silicone stent is then removed. However, stenosis is a frequently reported complication associated with this double‐layered tube (Ike et al, 1989; Natsume et al, 1993; Takimoto et al, 1998; Yamamoto et al, 1999a, c). Exceptional case was observed when the stent was retained in situ for more than 3 weeks to sustain the mechanical stability and applied in cervical (Takimoto et al, 1998) but not thoracic region (Yamamoto et al, 1999c) of the esophagus.…”

Section: Current Scaffold‐based Strategies In Esophageal Reconstructionmentioning

confidence: 99%

Esophageal tissue engineering: An in‐depth review on scaffold design

Tan

Chua

Leong

et al. 2011

Biotech & Bioengineering

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Treatment of esophageal cancer often requires surgical procedures that involve removal. The current approaches to restore esophageal continuity however, are known to have limitations which may not result in full functional recovery. In theory, using a tissue engineered esophagus developed from the patient's own cells to replace the removed esophageal segment can be the ideal method of reconstruction. One of the key elements involved in the tissue engineering process is the scaffold which acts as a template for organization of cells and tissue development. While a number of scaffolds range from traditional non-biodegradable tubing to bioactive decellularized matrix have been proposed to engineer the esophagus in the past decade, results are still not yet favorable with many challenges relating to tissue quality need to be met improvements. The success of new esophageal tissue formation will ultimately depend on the success of the scaffold being able to meet the essential requirements specific to the esophageal tissue. Here, the design of the scaffold and its fabrication approaches are reviewed. In this paper, we review the current state of development in bioengineering the esophagus with particular emphasis on scaffold design.

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Section: Current Scaffold‐based Strategies In Esophageal Reconstructionmentioning

confidence: 99%

Esophageal tissue engineering: An in‐depth review on scaffold design

Tan

Chua

Leong

et al. 2011

Biotech & Bioengineering

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“…Ike et al . reported that the migration occurred as soon as the oral feeding resumed . Takimoto et al .…”

Section: Discussionmentioning

confidence: 99%

“…Ike et al reported that the migration occurred as soon as the oral feeding resumed. 15 Takimoto et al considered that the early oral feeding was the immediate cause of anastomotic leakage and migration of artificial esophagus. 16 Our result was consistent with their viewpoints.…”

Section: Discussionmentioning

confidence: 99%

Experimental reconstruction of cervical esophageal defect with artificial esophagus made of polyurethane in a dog model

Jiang

Cui

et al. 2014

Dis Esophagus

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The defect of esophagus after surgical excision in patients is usually replaced by autologous stomach, jejunum, or colon. The operation brings severe trauma and complications. Using artificial esophagus to replace the defect in situ can reduce the operative trauma, simplify the operative procedures, and decrease the influence to digestive function. A variety of experiments have been designed for developing a practical artificial esophagus. Nevertheless, a safe and reliable artificial esophagus is not yet available. The objective is to evaluate the possibility of the artificial esophagus made of non-degradable polyurethane materials being used in reconstruction of the segmental defect of cervical esophagus in beagles, observe the regeneration of esophageal tissue, and gather experience for future study. The cervical esophageal defects in 13 beagles were designed to 2-cm long and were constructed by the artificial esophagus made of non-degradable polyurethane materials. Nutrition supports were given after the operation. The operative mortality, anastomotic leakage, migration of artificial esophagus, and dysphagia were followed up. The regeneration of the esophageal tissues was evaluated by histopathology and immunohistochemical labeled streptavidin-biotin method. The surgical procedures were successfully completed in all beagles, and 12-month follow-ups were done. Only one beagle died of severe infection, and all others survived until being killed. The anastomotic leakage occurred in nine beagles, most of them (8/9) were cured after supportive therapy. The migration of artificial esophagus occurred in all 12 surviving beagles, and one artificial esophagus stayed in situ after migration. All 12 surviving beagles showed dysphagia with taking only fluid or soft food. No beagle died of malnutrition. The neo-esophagus was composed of granulation tissue, and the inner surface was covered by epithelium in 2-3 months completely. But the inner surface of neo-esophagus with artificial esophagus staying in situ after migration was not covered by epithelium, and the granulation tissue was infiltrated by a great deal of inflammatory cells. Antibodies against cytokeratin were positively expressed in epithelium of neo-esophagus. Up to 12 months after operation, antibodies against smooth muscle actin and desmin were both negatively expressed in neo-esophagus. The artificial esophagus made of non-degradable polyurethane reconstructing cervical esophageal defect is practicable. Although there are some problems, including anastomotic leakage, migration, and dysphagia, they are not lethal following good supportive therapy. The esophageal epithelium can regenerate with the supporting role of artificial esophagus. In the future, deformable artificial esophagus should be improved, and a much longer follow-up will be performed to evaluate whether the esophageal gland and skeletal muscle can regenerate.

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“…Carachi evaluated the use of bioprostheses to relieve tension in oesophageal anastomosis in piglets [10]. Osamu studied neo-oesophageal epithelialisation following the replacement of the cervical oesophagus with collagen-coated silicon tubes in dogs [20]. However, the above-mentioned studies entailed anastomosis between the oesophageal edges and the edges of the synthetic tube.…”

mentioning

confidence: 99%

“…In this study, all lambs sucked milk from their mothers within an hour after surgery with no anastomotic leak or infection. There are a few reports in literature that have shown that oesophageal squamous mucosa does grow and bridge the gap between oesophageal edges [20,21]. However, none of those studies showed any muscle growth.…”

mentioning

confidence: 99%