Tracheal Replacement Using an In-Body Tissue-Engineered Collagenous Tube “BIOTUBE” with a Biodegradable Stent in a Beagle Model: A Preliminary Report on a New Technique

Shohei Hiwatashi; Yasuhide Nakayama; Satoshi Umeda; Yuichi Takama; Takeshi Terazawa; Hiroomi Okuyama

doi:10.1055/s-0038-1673709

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2019; 29(01): 090-096
DOI: 10.1055/s-0038-1673709

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Tracheal Replacement Using an In-Body Tissue-Engineered Collagenous Tube “BIOTUBE” with a Biodegradable Stent in a Beagle Model: A Preliminary Report on a New Technique

Shohei Hiwatashi

¹Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

,

Yasuhide Nakayama

²Department of Biomedical Engineering, NCVC Research Institute, Suita, Osaka, Japan

,

Satoshi Umeda

¹Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

,

Yuichi Takama

¹Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

,

Takeshi Terazawa

²Department of Biomedical Engineering, NCVC Research Institute, Suita, Osaka, Japan

,

Hiroomi Okuyama

¹Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

› Author Affiliations

Abstract

Introduction Tracheal reconstruction for long-segment stenosis remains challenging. We investigate the usefulness of BIOTUBE, an in-body tissue-engineered collagenous tube with a biodegradable stent, as a novel tracheal scaffold in a beagle model.

Materials and Methods We prepared BIOTUBEs by embedding specially designed molds, including biodegradable stents, into subcutaneous pouches in beagles. After 2 months, the molds were filled with ingrown connective tissues and were harvested to obtain the BIOTUBEs. The BIOTUBEs, cut to 10- or 20-mm lengths, were implanted to replace the same-length defects in the cervical trachea of five beagles. Endoscopic and fluoroscopic evaluations were performed every week until the lumen became stable. The trachea, including the BIOTUBE, was harvested and subjected to histological evaluation between 3 and 7 months after implantation.

Results One beagle died 28 days after 20-mm BIOTUBE implantation because of insufficient expansion and retention force of the stent. The remaining four beagles were implanted with a BIOTUBE reinforced by a strong stent, and all survived the observation period. Endoscopy revealed narrowing of the BIOTUBEs in all four beagles, due to an inflammatory reaction, but patency was maintained by steroid application at the implantation site and balloon dilatation against the stenosis. After 2 months, the lumen gradually became wider. Histological analyses showed that the internal surface of the BIOTUBEs was completely covered with tracheal epithelial cells.

Conclusion This study demonstrated the usefulness of the BIOTUBE with a biodegradable stent as a novel scaffold for tracheal regeneration.

Keywords

trachea replacement - congenital tracheal stenosis - tracheal scaffold - biodegradable stent - tissue engineered trachea

Full Text

References

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