Experimental Study Using PTFE (Goretex) Patches for Replacement of the Oesophageal Wall

Saez, Lourdes; Monreal, F. Arnal; Fernández, Salvador Pita; Cruz, José Juan Ribés

doi:10.1159/000070609

Cited by 8 publications

(3 citation statements)

References 4 publications

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“…Tubular-shaped constructs are difficult to be realized ( H.Nam et al, 2020 ), and many biomaterials have been proposed as scaffolds to promote esophageal tissue engineering reconstruction. Among them, gastric acellular matrices ( Urita et al, 2007 ), AlloDerm ® ( Isch et al, 2001 ), xenogeneic small intestinal submucosa (SIS) and urinary porcine bladder matrix (UBM) ( Badylak et al, 2000 ; Badylak et al, 2005 ; Poghosyan et al, 2015 ; Catry et al, 2017 ), porcine aorta ( Kajitani et al, 2001 ), esophageal acellular matrices ( Marzaro et al, 2006 ), retrievable synthetic scaffold carrying autologous cells ( La Francesca et al, 2018 ; Nam et al, 2020 ), mixed materials with bioinks ( Kajitani et al, 2001 ), PLC/PLGA (Polycaprolactone/poly(lactic-co-glycolic) acid) tubular scaffolds ( Jensen et al, 2015 ), non-absorbable materials such as polyethylene terephthalate, polyurethane electro-spun scaffold ( Miki et al, 1999 ), and silicone or expanded polytetrafluoroethylene ( Gonzalez Saez et al, 2003 ). Above all, the use of pre-seeded scaffolds for full-circumferential esophageal reconstruction resulted in higher degree of regeneration and lower inflammation rates with respect to scaffolds implanted alone ( Tan et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Decellularized esophageal tubular scaffold microperforated by quantum molecular resonance technology and seeded with mesenchymal stromal cells for tissue engineering esophageal regeneration

Marzaro

Pozzato²,

Tedesco³

et al. 2022

Front. Bioeng. Biotechnol.

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Current surgical options for patients requiring esophageal replacement suffer from several limitations and do not assure a satisfactory quality of life. Tissue engineering techniques for the creation of customized “self-developing” esophageal substitutes, which are obtained by seeding autologous cells on artificial or natural scaffolds, allow simplifying surgical procedures and achieving good clinical outcomes. In this context, an appealing approach is based on the exploitation of decellularized tissues as biological matrices to be colonized by the appropriate cell types to regenerate the desired organs. With specific regard to the esophagus, the presence of a thick connective texture in the decellularized scaffold hampers an adequate penetration and spatial distribution of cells. In the present work, the Quantum Molecular Resonance® (QMR) technology was used to create a regular microchannel structure inside the connective tissue of full-thickness decellularized tubular porcine esophagi to facilitate a diffuse and uniform spreading of seeded mesenchymal stromal cells within the scaffold. Esophageal samples were thoroughly characterized before and after decellularization and microperforation in terms of residual DNA content, matrix composition, structure and biomechanical features. The scaffold was seeded with mesenchymal stromal cells under dynamic conditions, to assess the ability to be repopulated before its implantation in a large animal model. At the end of the procedure, they resemble the original esophagus, preserving the characteristic multilayer composition and maintaining biomechanical properties adequate for surgery. After the sacrifice we had histological and immunohistochemical evidence of the full-thickness regeneration of the esophageal wall, resembling the native organ. These results suggest the QMR microperforated decellularized esophageal scaffold as a promising device for esophagus regeneration in patients needing esophageal substitution.

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Section: Discussionmentioning

confidence: 99%

Decellularized esophageal tubular scaffold microperforated by quantum molecular resonance technology and seeded with mesenchymal stromal cells for tissue engineering esophageal regeneration

Marzaro

Pozzato²,

Tedesco³

et al. 2022

Front. Bioeng. Biotechnol.

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“…Our intention is to find an alternative for short segment esophageal replacement, when the conventional organs (stomach, jejunum, large intestine) are not feasible for replacement. Various methods have been evaluated for replacement, with questionable results to date [4]- [9]. In a previous canine investigation a 5-cm-long esophageal segment was successfully replaced using a tracheal allograft [1].…”

Section: Discussionmentioning

confidence: 99%

Cryopreservation of the Trachea Can Reduce Its Antigenicity in Various Species

Juhasz¹,

Lippai²,

Novak³

et al. 2015

OJGas

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Background: Cryopreserved tracheal allograft has been used successfully for esophageal replacement in the canine model. The working hypothesis was cryopreservation decreases antigenicity but epithelial desquamation remains. However, cryopreservation of human tracheal samples collected at tracheostomy, resulted in no significant desquamation. The aim of this study was to examine the extent of desquamation of the epithelial layer of cryopreserved animal tracheas and find a reason for decreased antigenicity of cryopreserved canine and pig's trachea. Methods: 5 cm long tracheal segments were removed from 6 dogs and 125 pigs and stored in liquid nitrogen for 21 days. Cross section samples were taken from the end of the segment, 1 cm from the end and at the middle of the segment. Histological examination was performed using haematoxyllin-eosin and MHC-II antigen specific antibody staining. Changes in histological structure were analyzed. Results: General histological morphology of samples changed after cryopreservation. The percentage of intact epithelium and the overall intensity of immune-staining increased significantly from the ends to the middle of the segments, but the intensity of immune-staining showed no difference in the remaining epithelial cells. Conclusion: Cryopreservation damages the epithelial cells, but does not influence the cell's antigenicity or cause desepithelisation. The main effect is a retraction of the epithelial layer from the ends to the midpart and this effect may be protection against organ rejection. Based on our canine and pig results a 5 cm, long tracheal segment seems to be a promising organ for human esophageal replacement.

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“…Artificial materials (Dacron, polytetrafluorethylene, silicon) are used as foils and frequently led to stenosis due to extended development of fibrosis [9]. Though Gonzalez Saez et al [10] showed that PTFE patches are possible to suture and do not impede epithelialization, only scar tissue occurred and there was no muscle regeneration at the patch areas. Due to their pores, structure meshes combine permission of tissue infiltration and device stabilization.…”

Section: Introductionmentioning

confidence: 99%

Surgical Mesh as a Scaffold for Tissue Regeneration in the Esophagus

Jansen

Klinge²,

Anurov

et al. 2004

Eur Surg Res

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Background: Textiles in the form of surgical meshes are widely used in hernia surgery. Their porous structure allows tissue infiltration to incorporate the fabric for complete healing and device stabilization. This study was aimed to reconstitute the esophageal wall and to investigate the functional and histological consequences of a new, non-absorbable polyvinylidene fluoride (PVDF) mesh and an absorbable polyglactin 910 (Vicryl^®) mesh. Methods: Semicircular esophageal defects of 0.5 × 1 cm were created 2 cm proximal of the cardia in 10 rabbits. This gap was bridged using either polyglactin 910 or PVDF and additionally covered by omental wrapping. The clinical outcome was observed by clinical observation, regular esophagoscopies and X-ray contrast medium examinations. Local tissue regeneration was verified by light microscopy and immunohistochemistry. Results: After an observation period of 3 months we found no anastomotic strictures, complete mucosal regeneration, minimal inflammation reaction and initial regeneration of the muscle layer for the PVDF group. Within the polyglactin 910 group, three patch failures with consecutive anastomotic leakage occurred. Conclusion: The results indicate that PVDF mesh structure gives the opportunity of local tissue regeneration in the esophagus. Though re-epithelialization and muscle cell ingrowth could be detected for absorbable polyglactin 910 mesh, this implant was accompanied by a high and early rate of anastomotic leakage.

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Experimental Study Using PTFE (Goretex) Patches for Replacement of the Oesophageal Wall

Cited by 8 publications

References 4 publications

Decellularized esophageal tubular scaffold microperforated by quantum molecular resonance technology and seeded with mesenchymal stromal cells for tissue engineering esophageal regeneration

Decellularized esophageal tubular scaffold microperforated by quantum molecular resonance technology and seeded with mesenchymal stromal cells for tissue engineering esophageal regeneration

Cryopreservation of the Trachea Can Reduce Its Antigenicity in Various Species

Surgical Mesh as a Scaffold for Tissue Regeneration in the Esophagus

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