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

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.