Masanori Maeda1, Nobuo Kanai1, Shinichiro Kobayashi2, Takahiro Hosoi3, Ryo Takagi1, Takashi Ohki4, Yoshihiro Muragaki5, Masayuki Yamato1, Susumu Eguchi6, Fumio Fukai7, Teruo Okano1. 1. Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan. 2. Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. 3. Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Pharmaceutical Sciences, Graduate school of Pharmaceutical Science, Tokyo University of Science, Tokyo, Japan. 4. Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. 5. Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan. 6. Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. 7. Department of Pharmaceutical Sciences, Graduate school of Pharmaceutical Science, Tokyo University of Science, Tokyo, Japan.
Abstract
BACKGROUND: To prevent severe esophageal stenosis after aggressive endoscopic submucosal dissection (ESD), our group previously reported an efficient treatment using cell sheets that had been fabricated from patient cells. However, this transplantation procedure had not been easy for every endoscopist and needed to be improved to derive the full effect of epithelial cell sheets. OBJECTIVE: To develop an endoscopic device that enables easy and effective cell sheet transplantation and to evaluate its performance and clinical feasibility. DESIGN: Animal study. SETTING: Animal experimentation laboratory. INTERVENTION: Three pigs underwent circumferential esophageal ESD while under general anesthesia. A total of 12 cell sheets were endoscopically transplanted to the ESD site; 6 cell sheets were transplanted by using an endoscopic device that we developed, and 6 cell sheets were transplanted by using the conventional method. MAIN OUTCOME MEASUREMENTS: Procedure time, transplanted area on the ESD site, transplantation success rate, and monitoring of adverse events or incidents. RESULTS: The device allowed successful transplantation of all cell sheets with a shorter procedure time than with the conventional method (4.8 ± 0.8 minutes vs 13.3 ± 5.7 minutes, respectively) (P = .005) and onto a larger area (111.3 ± 56.3 mm(2) vs 41.8 ± 4.2 mm(2), respectively) (P = .023) with a higher success rate (100% vs 83%, respectively). No adverse incidents were monitored in each method. LIMITATIONS: Animal study, small sample. CONCLUSION: A newly designed endoscopic cell sheet transplantation device would be useful.
BACKGROUND: To prevent severe esophageal stenosis after aggressive endoscopic submucosal dissection (ESD), our group previously reported an efficient treatment using cell sheets that had been fabricated from patient cells. However, this transplantation procedure had not been easy for every endoscopist and needed to be improved to derive the full effect of epithelial cell sheets. OBJECTIVE: To develop an endoscopic device that enables easy and effective cell sheet transplantation and to evaluate its performance and clinical feasibility. DESIGN: Animal study. SETTING: Animal experimentation laboratory. INTERVENTION: Three pigs underwent circumferential esophageal ESD while under general anesthesia. A total of 12 cell sheets were endoscopically transplanted to the ESD site; 6 cell sheets were transplanted by using an endoscopic device that we developed, and 6 cell sheets were transplanted by using the conventional method. MAIN OUTCOME MEASUREMENTS: Procedure time, transplanted area on the ESD site, transplantation success rate, and monitoring of adverse events or incidents. RESULTS: The device allowed successful transplantation of all cell sheets with a shorter procedure time than with the conventional method (4.8 ± 0.8 minutes vs 13.3 ± 5.7 minutes, respectively) (P = .005) and onto a larger area (111.3 ± 56.3 mm(2) vs 41.8 ± 4.2 mm(2), respectively) (P = .023) with a higher success rate (100% vs 83%, respectively). No adverse incidents were monitored in each method. LIMITATIONS: Animal study, small sample. CONCLUSION: A newly designed endoscopic cell sheet transplantation device would be useful.
Authors: Magdalena Kasendra; Misty Troutt; Taylor Broda; W Clark Bacon; Timothy C Wang; Joyce C Niland; Michael A Helmrath Journal: Am J Physiol Gastrointest Liver Physiol Date: 2021-05-05 Impact factor: 4.871