An in vivo study was conducted to determine if an extracellular matrix (ECM) scaffold co-localized
with autologous muscle tissue could achieve constructive remodeling of esophageal
tissue without stricture. ECM derived from the porcine urinary bladder was processed,
decellularized, configured into a tube shape, and terminally sterilized for use as
a bioscaffold for esophageal reconstruction in a dog model. Twenty-two dogs were divided
into four groups, three groups of five and one group of seven. Groups 1 and 2 were
repaired with either ECM alone or muscle tissue alone, respectively. Groups 3 and
4 were repaired with ECM plus either a partial (30%) covering with muscle tissue or
a complete (100%) covering with muscle tissue, respectively. Animals in groups 1 and
2 were sacrificed within approximately 3 weeks because of the formation of intractable
esophageal stricture. Four of five dogs in group 3 and six of seven dogs in group
4 were survived for 26 days to 230 days and showed constructive remodeling of esophageal
tissue with the formation of well organized esophageal tissue layers, minimal stricture,
esophageal motility, and a normal clinical outcome. Mechanical testing of a subset
of the remodeled esophageal tissue from animals in groups 3 and 4 showed progressive
remodeling from a relatively stiff, non-compliant ECM tube structure toward a tissue
with near normal biomechanical properties. We conclude that ECM bioscaffolds plus
autologous muscle tissue, but not ECM scaffolds or muscle tissue alone, can facilitate
the in situ reconstitution of structurally and functionally acceptable esophageal tissue.
Key Words
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Article info
Publication history
Received:
December 13,
2004
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© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
