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World J Gastroenterol. Dec 21, 2012; 18(47): 6894-6899
Published online Dec 21, 2012. doi: 10.3748/wjg.v18.i47.6894
Esophagus and regenerative medicine
Ricardo Londono, Blair A Jobe, Toshitaka Hoppo, Stephen F Badylak
Ricardo Londono, Stephen F Badylak, McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, United States
Ricardo Londono, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, United States
Blair A Jobe, Toshitaka Hoppo, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA 15232, United States
Stephen F Badylak, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, United States
Stephen F Badylak, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, United States
Author contributions: Londono R and Badylak SF wrote the manuscript with assistance and editing by Jobe BA and Hoppo T; all authors have conducted some of the studies described in the manuscript.
Supported by Award Number T32EBO01026-08, from the National Institute of Biomedical Imaging and Bioengineering, in part
Correspondence to: Stephen F Badylak, DVM, MD, PhD, Department of Surgery, University of Pittsburgh, McGowan Institute for Regenerative Medicine, 450 Technology Drive, Suite 300, Pittsburgh, PA 15213, United States. badylaks@upmc.edu
Telephone: +1-412-6245253 Fax: +1-412-6245256
Received: April 19, 2012
Revised: June 13, 2012
Accepted: June 28, 2012
Published online: December 21, 2012
Abstract

In addition to squamous cell carcinoma, the incidence of Barrett’s esophagus with high-grade dysplasia and esophageal adenocarcinoma is rapidly increasing worldwide. Unfortunately, the current standard of care for esophageal pathology involves resection of the affected tissue, sometimes involving radical esophagectomy. Without exception, these procedures are associated with a high morbidity, compromised quality of life, and unacceptable mortality rates. Regenerative medicine approaches to functional tissue replacement include the use of biological and synthetic scaffolds to promote tissue remodeling and growth. In the case of esophageal repair, extracellular matrix (ECM) scaffolds have proven to be effective for the reconstruction of small patch defects, anastomosis reinforcement, and the prevention of stricture formation after endomucosal resection (EMR). More so, esophageal cancer patients treated with ECM scaffolds have shown complete restoration of a normal, functional, and disease-free epithelium after EMR. These studies provide evidence that a regenerative medicine approach may enable aggressive resection of neoplastic tissue without the need for radical esophagectomy and its associated complications.

Keywords: Esophageal repair, Biomaterial mediated esophageal repair, Extracellular matrix, Extracellular matrix scaffold