Esquiliano-Rendon DR, Raya-Rivera A, Parra-Barrera A, Nieto-Zermeño J, Ordorica-Flores R, Blanco-Rodriguez G, Valencia-Mayoral P, Penchyna-Grub J, Bracho-Blanchet E

Language: Spanish
References: 23
Page: 61-69
PDF size: 383.75 Kb.

ABSTRACT

Introduction: Every year about 5,000 are reported a10, 000 patients with congenital or acquired esophageal requiring surgical treatment, unlike the rest of the gastrointestinal tract is not possible to use autologous tissue for reconstruction because of its limited size and its delicate vascularity, which are used by complex procedures such as colon interposition, a field that has been growing and could provide a solution to these problems is tissue engineering. The purpose of this work involves the construction of a esophageal prosthesis from autologous cells implanted on a collagen matrix and test its usefulness in an animal model.
Material and Methods: We took a biopsy of healthy esophageal tissue at the neck of healthy rabbits, which were processed to desegregate its cellular components in epithelial and muscle cell viability was verified by MTT method and their presence by electron microscopy scanning. The prosthesis was implanted in a second surgery to create a defect in “patch” in the native esophagus, further studies of endoscopy, esophagogram and necropsy in animals.
Results: After the biopsy epithelial and muscle cells were isolated and multiplied sown and harvested in Petri dishes and seeded at a concentration of 1x! 07 cel/cm2 in intestinal submucosa prostheses. Subsequently, the prostheses were implanted in four healthy rabbits N = 5, all rabbits subsequently underwent esophagogram and endoscopy studies, observing proper integration of the now called neoesófago, with adequate passage of contrast medium showed no leakage or stenosis, all animals remained alive, feeding by mouth without complications so far from being slaughtered except one who died for reasons unconnected with the study. In histopathological studies, there is an almost normal architecture neoesófago presence of mucosa and muscle layer proper.
Conclusion: In this study we establish the conditions, general characterization for the isolation and multiplication of epithelial cells and muscle tissue healthy esophageal also created an esophageal prosthesis, which could be implanted in animals to which a defect was created 50 % of the light of it with proper integration of the now called neoesófago. All animals remained alive feeding by mouth without complications, which lays the basis for developing an esophageal prosthesis in the future which can be used in the treatment of children with congenital or acquired esophageal lesions.

REFERENCES

1. Lillehei GW, Shamberger RC. Reoperative esophageal surgery. Sem Pediatr Surg 2003;12:100- 106

2. Spitz L. Esophageal atresia: past, present, and future.J Pediatr Surg 1996; 31: 19-25

3. Ein SH.Gastric tubes in children with causticesophageal injury: a 32-year review. J Pediatr Surg 1998; 33:1363-1365

4. Saeki M, Tsuchida Y, Ogada T, et al. Long term results of jejunal replacement of the esophagus. J pediatr Surg 1988; 23:483-489

5. Hendren WH, Hendren WG. Colon interpositionfor esophagus in children. J Pediatr Surg 1985;20:829-839

6. Ahmad SA, Silvestre KG, Hebra A, et al. Esophagealreplacemen using the colon: is it a good choice?. J Pediatr Surg 1996;31:1026-1030

7. Erdogan E, Emir H, Eroglu E, et al. Esophageal replacement using the colon: a 15-year review. Pediatr Surg Int 2000;16:546-549

8. Raffensperger JG, Luck SR, Reynolds M, et al. Intestinal Bypass of the esophagus. J Pediatr Surg 1996;31:38-47

9. Mayoral W. The esophacoil stent for malignant esophageal obstruction. Gastrointest Endosc Clin North Am 1999;9:423-430

10. Aziz D, Schiller D, Gerstle JT, Ein SH, langer JC. Can “Long- Gap” esophageal atresia be safely managed at home while awaiting anastomosis. J pediatr Surg 2003;38:705-708

11. Chen HC, Tang YB. Microsurgical reconstruction of the esophagus. Semin Surg Oncol 2000;19;235-245

12. Langer R, Vacanti JP. Tissue Engineering. Science 1993;260:920-926

13. Grikscheit TC, Vacanti JP. The History and current status of tissue engineering: the future of pediatric surgery. J Pediatr Surg 2002;37:277-288

14. Badylak SF. The extracelular matrix as a scaffold for tissue reconstruction. Cell Develop Biol 2002;13:377-383

15. Kropp BP, Cheng EY, Pope IV JC, Brock III JW, Koyle MA, Furness PD, et al. Use of small intestinal submucosa for corporal body grafting in cases of severe penile curvature. J Urol 2002;168:1742- 1745

16. Prevel CD, Eppley BL, Summerlin DJ, et al. Small intestinal submucosa (SIS): Utilization as a wound dressing in full-thickness rodent wounds. J Plast Surg 1995;35:381-388

17. Cob MA Badylak SF, janas W, et al. Histology after dural grafting with small intestinal submucosa. Surg Neurol 1996;46:389-394

18. Grossklaus DJ, Shappell SB, Adams MC, Brock III JW, Pope IV JC. Small intestinal submucosa as a urethral coverage layer. J Urol 2001;166

19. Yamamoto y, Nakamura T, Shimizu Y, Matsumoto K, Takimoto Y, Kiyotani T, et al. Intrathoracic esophageal replacement in the dog with the use of an artificil esophagus composed of a collagen sponge with double-layered silicone tube. J thorac Cardiovasc Surg 1999;118:276-286

20. Barnes W, Redo F, Ogata K. Replacement of portion of canine esophagus with composite prótesis and greater omentum. J Thorac Cardiovasc Surg 1972;64:892-896

21. Takimoto Y, Nakamura T, Yamamoto Y, Kiyotani T, Teramachi M, Shimizu Y. The experimental replacement of a cervical esophageal segment with an artificial prosthesis with the use of collagen matrix and a silicone stent. J Thorac Cardiovasc Surg 1998;116:98-106

22. Sandusky GE, Badylak SF, Morff RJ, Johnson WD, Lantz GC. Histologic findings after in vivo placement of small intestine submucosa vascular grafts and saphenous vein grafts in the carotide artery in dogs. Am J Pathol 1992;140:317-321

23. Karmiol S. Cell isolation and selection. En: Atala A, Lanza RP, editores Methods of tissue engineering. New York: Academic Press;2002. p.19-35.