Resorbable bioscaffold for esophageal repair in a dog model

Purpose: Porcine-derived, xenogeneic extracellular matrix (ECM) derived fro m either the small intestinal submucosa (SIS) or urinary bladder submucosa (UBS) was used as a tissue scaffold for esophageal repair in a dog model. Methods: Patch defects measuring approximately 5 cm in length and encompass ing 40% to 50% of the circumference of the esophagus or complete circumfere ntial segmental defects measuring 5 cm in length were created by surgical r esection in healthy adult female dogs. The defects were repaired with ECM s caffolds derived from either SIS or UBS. The animals were kept alive for pe riods ranging from 4 days to 15 months. Results: The xenogeneic scaffolds used for repair of the patch defects were resorbed completely within 30 to 60 days and showed replacement by skeleta l muscle, which was oriented appropriately and contiguous with adjacent nor mal esophageal skeletal muscle, organized collagenous connective tissue, an d a complete and intact squamous epithelium. No signs of clinical esophagea l dysfunction were seen in any of the animals with the patch defect repair. The xenogeneic scaffolds configured into tubes for repair of the segmental defects all showed stricture within 45 days of surgery. Conclusion: These ECMs show promise as a treatment option for esophageal re pair, but stricture remains problematic for complete tube grafts. Copyright (C) 2000 by W.B. Saunders Company.