Purpose: Esophagus replacement using the present surgical techniques is associated with significant morbidity. Tissue engineering of the esophagus may provide the solution for esophageal loss. In our attempts to engineer the esophagus, this study aimed to investigate the feasibility of generating vascularized in situ esophageal conduits using the ovine model.
Methods: Esophageal biopsies were obtained from lambs, and ovine esophageal epithelial cells (OEEC) were proliferated. The OEEC were seeded on to bovine collagen sheets preseeded with fibroblasts. After 2 weeks of maintaining the constructs in vitro, the constructs were tubularized on stents to create a tube resembling the esophagus and implanted into the omentum for in situ tissue engineering. The edges of the omentum were sutured using nonabsorbable suture material. The implanted constructs were retrieved after 8 and 12 weeks.
Results: The omental wrap provided vascular growth within and around the constructs as they were integrated along the outer surface area of the scaffold. After removal of the stents, the engineered conduit revealed a structure similar to the esophagus. Histologic investigations demonstrated esophageal epithelium organization into patches on the luminal side and vascular ingrowths on the conduit's outer perimeter.
Conclusion: Our study demonstrated the seeding of OEEC on collagen scaffolds and formation of a rudimentary conduit resembling esophageal morphology after in situ omental implantation. Vascular coverage and ingrowth in the periphery of the construct could also be demonstrated. These findings hold future promise for the engineering of the esophagus with improved microarchitecture.
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