Cardiovascular Research Institute, 13155Yokohama City University, Yokohama, Kanagawa, Japan.
Department of Physiology, 13112Tokyo Medical University, Tokyo, Japan.
Cell Transplant. 2021 Jan-Dec;30:9636897211009559. doi: 10.1177/09636897211009559.
Colorectal anastomotic leakage is one of the most feared and fatal complications of colorectal surgery. To date, no external coating material that can prevent anastomotic leakage has been developed. As myoblasts possess anti-inflammatory capacity and improve wound healing, we developed a multilayered human skeletal muscle myoblast (HSMM) sheet by periodic exposure to supraphysiological hydrostatic pressure during repeated cell seeding. We assessed whether the application of an HSMM sheet can promote the healing process after colonic anastomosis. Partial colectomy and insufficient suturing were employed to create a high-risk colo-colonic anastomosis model in 60 nude rats. Rats were divided into a control group ( = 30) and an HSMM sheet group ( = 30). Macroscopic findings, anastomotic bursting pressure, and histology at the colonic anastomotic site were evaluated on postoperative day (POD) 3, 5, 7, 14, and 28. The application of an HSMM sheet significantly suppressed abscess formation at the anastomotic site compared to the control group on POD3 and 5. The anastomotic bursting pressure in the HSMM sheet group was higher than that in the control group on POD3 and 5. Inflammatory cell infiltration in the HSMM sheet group was significantly suppressed compared to that in the control group throughout the time course. Collagen deposition in the HSMM sheet group on POD3 was significantly abundant compared to that in the control group. Regeneration of the mucosa at the colonic anastomotic site was promoted in the HSMM sheet group compared to that in the control group on POD14 and 28. Immunohistochemical analysis demonstrated that surviving cells in the HSMM sheet gradually decreased with postoperative time and none were detected on POD14. These results suggest that the application of a multilayered HSMM sheet may prevent postoperative colonic anastomotic leakage.
结直肠吻合口漏是结直肠手术后最令人恐惧和致命的并发症之一。迄今为止,尚未开发出能预防吻合口漏的外涂层材料。由于成肌细胞具有抗炎能力并能促进伤口愈合,我们通过在反复细胞接种过程中周期性地暴露于超生理静水压力下,开发了一种多层人骨骼肌成肌细胞(HSMM)片。我们评估了 HSMM 片的应用是否能促进结直肠吻合后的愈合过程。在 60 只裸鼠中采用部分结肠切除术和不足的缝合来创建高风险的结肠-结肠吻合模型。将大鼠分为对照组(n=30)和 HSMM 片组(n=30)。在术后第 3、5、7、14 和 28 天评估结肠吻合部位的大体观察结果、吻合口爆裂压和组织学。与对照组相比,HSMM 片组在术后第 3 和 5 天吻合部位的脓肿形成明显减少。HSMM 片组的吻合口爆裂压在术后第 3 和 5 天高于对照组。HSMM 片组的炎症细胞浸润在整个时间过程中明显低于对照组。HSMM 片组在术后第 3 天的胶原沉积明显多于对照组。与对照组相比,HSMM 片组在术后第 14 和 28 天促进了结肠吻合部位的黏膜再生。免疫组织化学分析表明,HSMM 片内的存活细胞随着术后时间的推移逐渐减少,在术后第 14 天未检测到。这些结果表明,应用多层 HSMM 片可能预防术后结肠吻合口漏。