Institute of Advanced Biomedical Engineering and Science, Institute of Gastroenterology, Tokyo Women's Medical University (TWIns), Tokyo, Japan.
Gastrointest Endosc. 2012 Oct;76(4):873-81. doi: 10.1016/j.gie.2012.06.017. Epub 2012 Aug 4.
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.
To evaluate the efficacy of cultured autologous epidermal cell sheets to prevent severe esophageal constriction after circumferential ESD.
Animal study.
University institute.
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.
Weight gain, degree of mucosal constriction, and histological assessments.
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.
Animal study, small sample size.
Fabricated autologous skin epidermal cell sheets would be useful in preventing severe esophageal constriction after circumferential ESD.
内镜黏膜下剥离术（ESD）是治疗早期食管癌的一种公认方法。然而，大面积黏膜切除，如环形 ESD，会导致严重的狭窄形成。
评估培养的自体表皮细胞片预防环形 ESD 后严重食管狭窄的疗效。
动物研究。
大学研究所。
8 头猪在全身麻醉下接受环形食管 ESD。在 4 头猪中，在 ESD 后立即将自制的自体表皮细胞片经内镜移植到中央 ESD 部位。另外 4 头猪仅接受环形 ESD。在 ESD 后 1 周和 2 周进行尸检和组织学评估。
体重增加、黏膜狭窄程度和组织学评估。
对照组所有猪在 2 周后均出现严重食管狭窄。对照组和移植组的体重分别增加了-10.3%和 0.3%（P =.03），平均狭窄程度分别为 88%和 56%（P <.01）。移植组观察到早期再上皮化和轻微的肌层纤维化。
动物研究，样本量小。
制作的自体表皮细胞片有助于预防环形 ESD 后严重的食管狭窄。
