title: Fabricated autologous epidermal cell sheets for the prevention of esophageal stricture after circumferential ESD in a porcine model.
abstract: BACKGROUND
  Endoscopic submucosal dissection (ESD) is an accepted treatment for early esophageal carcinoma. However, resection of a large mucosal area, as with circumferential ESD, induces severe stricture formation.
  
  
  OBJECTIVE
  To evaluate the efficacy of cultured autologous epidermal cell sheets to prevent severe esophageal constriction after circumferential ESD.
  
  
  METHODS
  Animal study.
  
  
  METHODS
  University institute.
  
  
  METHODS
  Eight pigs underwent circumferential esophageal ESD while under general anesthesia. In 4 pigs, fabricated autologous epidermal cell sheets were endoscopically transplanted to the central ESD sites immediately after the ESD. The other 4 pigs underwent circumferential ESD only. Necropsy and histological assessment were performed at 1 and 2 weeks post-ESD.
  
  
  METHODS
  Weight gain, degree of mucosal constriction, and histological assessments.
  
  
  RESULTS
  All pigs in the control group showed severe esophageal constriction after 2 weeks. The control and transplanted groups had weight gains of -10.3% and 0.3% (P = .03), respectively, and the mean degrees of constriction were 88% and 56% (P < .01), respectively. Early re-epithelialization and mild fibrosis in the muscularis were observed in the transplanted group.
  
  
  CONCLUSIONS
  Animal study, small sample size.
  
  
  CONCLUSIONS
  Fabricated autologous skin epidermal cell sheets would be useful in preventing severe esophageal constriction after circumferential ESD.
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Institute of Gastroenterology, Tokyo Women's Medical University (TWIns), Tokyo, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kanai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamato
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ohki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Teruo
authors.initials: T
authors.lastname: Okano
mesh_terms: D000818:Animals; D000078404:Epidermal Cells; D004847:Epithelial Cells / Q000637:transplantation*; D004940:Esophageal Stenosis / Q000209:etiology / Q000517:prevention & control*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology / Q000601:surgery*; D005260:Female; D048091:Guided Tissue Regeneration / Q000379:methods*; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D062326:Re-Epithelialization; D013552:Swine; D023822:Tissue Engineering / Q000379:methods; D014182:Transplantation, Autologous