Department of Digestive Surgery, University Hospital Haut-Lévêque, Av de Magellan, 33604 Pessac cedex, France.
Expert Rev Med Devices. 2014 Mar;11(2):225-41. doi: 10.1586/17434440.2014.870470. Epub 2014 Jan 6.
Esophageal tissue engineering is still in an early state, and ideal methods have not been developed. Since the beginning of the 20th century, advances have been made in the materials that can be used to produce an esophageal substitute. Three approaches to scaffold-based tissue engineering have yielded good results. The first development concerned non-absorbable constructs based on silicone and collagen. The need to remove the silicone tube is the main disadvantage of this material. Polymeric absorbable scaffolds have been used since the 1990s. The main polymeric material used is poly (glycolic) acid combined with collagen. The problem of stenosis remains prevalent in most studies using an absorbable construct. Finally, decellularized scaffolds have been used since 2000. The promises of this new approach are unfulfilled. Indeed, stenosis occurs when the esophageal defect is circumferential regardless of the scaffold materials. Cell supplementation can decrease the rate of stenosis, but the type(s) of cells and their roles have not been defined. Finally, esophageal tissue engineering cannot provide a functional esophageal substitute, and further development is necessary prior to conducting human clinical studies.
食管组织工程仍处于早期阶段,尚未开发出理想的方法。自 20 世纪初以来,可用于生产食管替代品的材料取得了进展。基于支架的组织工程有三种方法取得了良好的效果。第一个发展涉及基于硅酮和胶原蛋白的不可吸收结构。需要移除硅酮管是这种材料的主要缺点。自 20 世纪 90 年代以来,已经使用了可吸收的聚合物支架。使用的主要聚合物材料是聚(乙醇酸)与胶原蛋白结合。在大多数使用可吸收结构的研究中,狭窄仍然很普遍。最后,自 2000 年以来已经使用了脱细胞支架。这种新方法的前景尚未实现。事实上,无论支架材料如何,当食管缺损呈环形时,都会发生狭窄。细胞补充可以降低狭窄的发生率,但尚未确定细胞的类型及其作用。最后,食管组织工程不能提供功能性的食管替代品,在进行人体临床研究之前,还需要进一步的发展。