JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Nakase, Y.
Right arrow Articles by Hagiwara, A.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Nakase, Y.
Right arrow Articles by Hagiwara, A.
Related Collections
Right arrow Esophagus - other
Right arrowRelated Article

J Thorac Cardiovasc Surg 2008;136:850-859
© 2008 The American Association for Thoracic Surgery

General Thoracic Surgery

Intrathoracic esophageal replacement by in situ tissue-engineered esophagus

Yuen Nakase, MD, PhDa,e,*, Tatsuo Nakamura, MD, PhDb, Shuichi Kin, MD, PhDa, Susumu Nakashima, MD, PhDa, Tetsuji Yoshikawa, MD, PhDa, Yoshiaki Kuriu, MD, PhDa, Chohei Sakakura, MD, PhDa, Hisakazu Yamagishi, MD, PhDa, Junji Hamuro, PhDc, Yoshito Ikada, PhDd, Eigo Otsuji, MD, PhDa, Akeo Hagiwara, MD, PhDe

a Department of Surgery and Regenerative Medicine, Division of Surgery and Physiology of Digestive System, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
b Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
c Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
d Department of Bioenvironmental Medicine, Nara Medical University, Nara, Japan
e Department of Medical Life Systems, Doshisha University, Kyoto, Japan

Received for publication November 2, 2007; revisions received February 26, 2008; accepted for publication May 4, 2008.

* Address for reprints: Yuen Nakase, MD, PhD, Department of Surgery and Regenerative Medicine, Division of Surgery and Physiology of Digestive System, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji Kajiicho 465, Kamigyo-ku, Kyoto 602-8566, Japan. (Email: yuen-n{at}koto.kpu-m.ac.jp).

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(+) 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(–) group, strictures developed after esophageal replacement, with almost complete obstruction within 2 to 3 weeks. In contrast, in the KF(+) 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.

Abbreviations and Acronyms {alpha}-SMA = {alpha}-smooth muscle actin; ITEE = in situ tissue-engineered esophagus; PBS = phosphate-buffered saline; PGA = polyglycolic acid


Related Article

The short esophagus: Intraoperative assessment of esophageal length
Sandro Mattioli, Maria Luisa Lugaresi, Mario Costantini, Alberto Del Genio, Natale Di Martino, Landino Fei, Uberto Fumagalli, Vincenzo Maffettone, Luigi Monaco, Mario Morino, Fabrizio Rebecchi, Riccardo Rosati, Mauro Rossi, Stefano Santi, Vincenzo Trapani, and Giovanni Zaninotto
J. Thorac. Cardiovasc. Surg. 2008 136: 834-841. [Abstract] [Full Text] [PDF]





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 by The American Association for Thoracic Surgery.