School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore.
Department of Cell and Tissue Engineering, Institute of Bioengineering and Nanotechnology, Singapore, Singapore.
Lancet Oncol. 2015 Feb;16(2):e84-92. doi: 10.1016/S1470-2045(14)70410-3.
Removal of malignant tissue in patients with oesophageal cancer and replacement with autologous grafts from the stomach and colon can lead to problems. The need to reduce stenosis and anastomotic leakage after oesophagectomy is a high priority. Developments in tissue-engineering methods and cell-sheet technology have improved scaffold materials for oesophageal repair. Despite the many successful animal studies, few tissue-engineering approaches have progressed to clinical trials. In this Review, we discuss the status of oesophagus reconstruction after surgery. In particular, we highlight two clinical trials that used decellularised constructs and epithelial cell sheets to replace excised tissues after endoscopic submucosal dissection or mucosal resection procedures. Results from the trials showed that both decellularised grafts and epithelial-cell sheets prevented stenosis. By contrast, animal studies have shown that the use of tissue-engineered constructs after oesophagectomy remains a challenge.
将恶性组织从食道癌患者体内切除并用胃和结肠的自体移植物替代可能会引发问题。减少食道癌手术后狭窄和吻合口漏的需求是重中之重。组织工程方法和细胞片技术的发展改善了食管修复的支架材料。尽管有许多成功的动物研究，但很少有组织工程方法进展到临床试验。在这篇综述中，我们讨论了手术后食管重建的现状。特别是，我们强调了两项临床试验，这些临床试验使用脱细胞构建物和上皮细胞片在经内镜黏膜下剥离术或黏膜切除术等程序后替代切除的组织。试验结果表明，脱细胞移植物和上皮细胞片都能防止狭窄。相比之下，动物研究表明，在食道癌手术后使用组织工程构建物仍然具有挑战性。
