Serial evaluation of segmental esophageal reconstruction using a polyurethane scaffold in a pig model

Tiffany L. Sarrafian, Jennifer L. Brazzell, Matthew Barron, Johnathon Aho, Ellen Blanco, Chelsea Powell, Jed Johnson, Dennis A. Wigle

Research output: Contribution to journalArticlepeer-review


Background: Many esophageal pathologies are clinically treated by resection and reconstruction of the esophagus. Surgical esophagectomy remains a morbid procedure and despite minimally invasive advances, has changed little in decades. Novel approaches to esophageal segmental resection and reconstruction are an unmet need. Methods: Circumferential thoracic esophageal transection was performed in both male and female pigs and the defects reconstructed using 5 or 10 cm polyurethane (PU) tubular grafts and stented. A subset were treated with stent only. Animals were survived to 14, 30, 60, and 399 days. Tissues were evaluated histologically, and via non-invasive serial endoscopy and contrast swallowing studies in long-term animals. Results: Luminal patency was achieved in all animals with no clinical evidence of leak. In short-term animals, there was healing noted in all cases with a variably sized region of ulceration remaining at the most central part of the repaired tube (between the proximal and distal anastomosis). In four long-term animals following stent removal, two resumed normal diet and thrived, while two animals were euthanized prior to the proposed endpoint because of stricture formation and inability to tolerate a normal diet. Re-epithelialization was observed in all groups, and more complete over time. Conclusions: The PU scaffold provides a matrix across which formation of new tissue can occur. The mechanisms through which this happens remain unclear, but likely a combination of fibrosis and tissue contraction, in conjunction with new tissue formation.

Original languageEnglish (US)
Pages (from-to)1830-1839
Number of pages10
JournalJournal of Thoracic Disease
Issue number6
StatePublished - Jun 2022


  • Porcine
  • circumferential defect
  • esophageal regeneration
  • scaffold

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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