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The journal «ONCOSURGERY» 2012, Vol.4, No 3

Clinical aspects of bioengineering pharyngeal reconstruction in cancer patients

Chissov VI, Reshetov IV, Vasiliev AV, Kravtsov SА, Terskikh VV, Batukhtina ЕV, Filushin ММ, Rogovaya ОS, Andreeva YuYu, Rebrikova IV

PA Herzen Moscow Cancer Research Institute Russia, NK Koltzov Institute of developmental biology, Moscow, Russia
Contact: Rebrikova IV, e-mail:

The objective: to develop multicomponent transplantat including elements of autotissue and allogenic cell cultures for closure of combined pharyngeal defects in cancer patients after removal of malignant tumors using fat tissue equivalent.

Materials and methods: the application of bioengineered autotransplantats with tissue equivalent in 20 cancer patients was analyzed.

For hypopharyngeal reconstruction we used advanced muscular or musculocutaneous graft consisted of pectoralis major with previously implanted mucosal tissue equivalent. The tissue graft-equivalent constituted 3-dimensional collagen gel with embedded fibroblasts and growing on its surface epidermal keratinocytes.

For convenience fixation of tissue equivalent polymer mesh of biocompatible material was incorporated. Soft tissue defect reconstruction of oropharyngeal region was performed with muscular portion of graft, mucous layer was restored by tissue eqiuvalent.

Limited clinical application of reconstruction of upper respiratory tract with tissue equivalent was approved by Scientific board and Ethics committee of PA Herzen Moscow Cancer Research Institute.

Results: the tissue equivalent contained stem cells provided reliable engraftment in the recipient tissue area and modified wound surface, inducing native wound epithelization. The use of tissue equivalent allowed to achieve restoration of hypopharyngeal continuity and function in all surgically operated patients.

Conclusions:

  1. The hypopharyngeal reconstruction with fat tissue equivalent is a reliable method of anatomical and functional restoration of organ.
  2. The tissue equivalent provides epithelization of hypopharingeal defect in majority of patients by 30 days regardless the previous cancer treatment.
  3. The developed orthotopic hypopharyngeal reconstruction with tissue bioengineering allows to achieve benefit functional rehabilitation in 100% of patients.

KEY WORDS: tissue equivalent, cell technologies, hypopharyngeal defect, bioengineering.

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