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A bioabsorbable polymer patch for the treatment of esophageal defect in a porcine model

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Abstract

Background

Although several materials have been used to replace the esophagus, none of the materials appears to be feasible for clinical use. Our group has developed a bioabsorbable polymer that can be used to repair the defects of stomach, small intestine, biliary tract, and veins. In this study, we implanted a bioabsorbable polymer patch (BAPP) into an esophageal defect and we investigated the clinical utility of BAPP and evaluated the process of esophageal regeneration.

Methods

Pigs (n = 9) underwent right thoracotomy under general anesthesia. A 4 × 2-cm oval-shaped portion of the esophageal wall was excised, and a BAPP was implanted at the excision site. Esophageal endoscopy was performed at 2 weeks after the implantation. At 4, 8, and 12 weeks after implantation, the whole esophagus was resected for gross and histological examinations of the graft sites.

Result

Esophageal endoscopy at 2 weeks revealed a tiny ulceration at the implantation site with no stenosis. At 4 weeks, the epithelium at the graft site was similar to that of the native esophagus, but it lacked a proper muscle layer. At 8 weeks, a rough muscle layer had developed. At 12 weeks, normal mucosa and a proper muscle layer similar to that of the native wall were confirmed.

Conclusion

BAPP repaired the defective esophageal wall without complications, and a neo esophageal wall identical to the native esophageal wall had formed by 12 weeks after implantation. Hence, this newly designed substitute has the potential for application as a novel treatment for defective esophagus.

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Acknowledgments

This study was supported by grants from the Gastrointestinal Cancer Project funded by Nakayama Cancer Research Institute and Grant-in-Aid for Scientific Research (KAKEN C) in Japan.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Masayasu Aikawa, Mitsuo Miyazawa, Kojun Okamoto, Katsuya Okada, Naoe Akimoto, Hiroshi Sato, Isamu Koyama & Shigeki Yamaguchi

  2. Division of Life Science, Nara Medical University, Nara, Japan

    Yoshito Ikada

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  1. Masayasu Aikawa
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  2. Mitsuo Miyazawa
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  4. Katsuya Okada
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  9. Yoshito Ikada
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Correspondence to Masayasu Aikawa.

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Aikawa, M., Miyazawa, M., Okamoto, K. et al. A bioabsorbable polymer patch for the treatment of esophageal defect in a porcine model. J Gastroenterol 48, 822–829 (2013). https://doi.org/10.1007/s00535-012-0716-7

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  • DOI: https://doi.org/10.1007/s00535-012-0716-7

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