title: Cell Sheet Transplantation for Esophageal Stricture Prevention after Endoscopic Submucosal Dissection in a Porcine Model.
abstract: OBJECTIVE
  Extended esophageal endoscopic submucosal dissection (ESD) is highly responsible for esophageal stricture. We conducted a comparative study in a porcine model to evaluate the effectiveness of adipose tissue-derived stromal cell (ADSC) double cell sheet transplantation.
  
  
  METHODS
  Twelve female pigs were treated with 5 cm long hemi-circumferential ESD and randomized in two groups. ADSC group (n = 6) received 4 double cell sheets of allogenic ADSC on a paper support membrane and control group (n = 6) received 4 paper support membranes. ADSC were labelled with PKH-67 fluorophore to allow probe-based confocal laser endomicroscopie (pCLE) monitoring. After 28 days follow-up, animals were sacrificed. At days 3, 14 and 28, endoscopic evaluation with pCLE and esophagography were performed.
  
  
  RESULTS
  One animal from the control group was excluded (anesthetic complication). Animals from ADSC group showed less frequent alimentary trouble (17% vs 80%; P = 0.08) and higher gain weight on day 28. pCLE demonstrated a compatible cell signal in 4 animals of the ADSC group at day 3. In ADSC group, endoscopy showed that 1 out of 6 (17%) animals developed a severe esophageal stricture comparatively to 100% (5/5) in the control group; P = 0.015. Esophagography demonstrated a decreased degree of stricture in the ADSC group on day 14 (44% vs 81%; P = 0.017) and day 28 (46% vs 90%; P = 0.035). Histological analysis showed a decreased fibrosis development in the ADSC group, in terms of surface (9.7 vs 26.1 mm²; P = 0.017) and maximal depth (1.6 vs 3.2 mm; P = 0.052).
  
  
  CONCLUSIONS
  In this model, transplantation of allogenic ADSC organized in double cell sheets after extended esophegeal ESD is strongly associated with a lower esophageal stricture's rate.
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité, Laboratory of biosurgical research, UMR-U633, 56 rue Leblanc, 75015 Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Perrod
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité, Laboratory of biosurgical research, UMR-U633, 56 rue Leblanc, 75015 Paris, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rahmi
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Pidial
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Assistance Publique-Hôpitaux de Paris, Department of Pathology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Camilleri
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité Assistance Publique-Hôpitaux de Paris, Department of Radiology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bellucci
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.
authors.forename: Amaury
authors.initials: A
authors.lastname: Casanova
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Viel
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité Assistance Publique-Hôpitaux de Paris, Department of Radiology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tavitian
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Cellier
authors.affiliation: Université Paris Descartes Sorbonne Paris cité, Laboratoire imagerie de l'angiogenèse et plateforme d'imagerie du petit animal, UMR-S970, 56 rue Leblanc, 75015 Paris, France.|Université Paris Descartes Sorbonne Paris cité Assistance Publique-Hôpitaux de Paris, Department of Radiology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Clement
mesh_terms: D050153:Abdominal Fat / Q000473:pathology; D000818:Animals; D018929:Cell Culture Techniques; D002478:Cells, Cultured; D004210:Dissection; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000601:surgery; D004940:Esophageal Stenosis / Q000209:etiology / Q000517:prevention & control*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D011183:Postoperative Complications / Q000517:prevention & control*; D011859:Radiography; D033581:Stem Cell Transplantation / Q000379:methods*; D034421:Sus scrofa