Histologic Evaluation after Full-Thickness Gastric Defect Repair with Porcine Small Intestine Submucosa Graft.
Abstracts
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Introduction: Porcine derived small intestine submucosa (SIS) has been used as a bioscaffold for tissue regeneration in a variety of body locations; however, its use for remodeling gastrointestinal defects has been poorly investigated. We previously demonstrated the feasibility of SIS for grafting gastric perforations. The purpose of this study was to investigate histologic findings after implantation of a SIS graft in the stomach of rats. Methods: A double SIS patch was used to seal a 1 cm full-thickness gastric defect in twelve rats (320g). The graft was secured with sutures taken from the seromuscular layer and placed within 1 mm of the edge of the patch. After 21 days the animals were euthanized and the stomach harvested for histologic examination. The grafted area surrounded by intact gastric tissue was excised and fixed in 10 per cent neutral buffered formalin. Cross sections of the grafted area were processed for paraffin embedding and 4-micron sections were stained with Hematoxylin and Eosin. A single pathologist reviewed all specimens. Results: All animals survived and thrived over the 3-week post-operative period. They gained weight and had no evidence of perforation. In all animals, the defect was completely closed by granulation tissue and early fibrosis. The granulation tissue replaced all layers of the gastric wall including submucosa, muscularis propria and subserosal fat. Although the majority of the luminal surface of the grafted areas remained ulcerated, early regeneration of normal mucosa was seen at the periphery of the defect that resembles native tissue. Conclusion: In promoting healing in the gut, SIS has shown to serve as a bioscaffold for regeneration of normal tissue. SIS may have application in patients with high-risk anastomoses and as such warrants further investigation. |
