Anastomotic leakage prevention using dry-preserved fibroblast cell sheets in esophageal reconstruction.

Background: Anastomotic leakage is a common and serious complication of esophageal reconstruction, and new methods are required for its prevention in clinical settings. We herein developed dry-preserved fibroblast cell sheets (dry sheets), which are easy to use and promote wound healing. This study aimed to investigate the efficacy of transplanting allogeneic dry sheets in preventing anastomotic leakage in a rat esophageal reconstruction model. Methods: Allogeneic dry sheets were prepared from the rat oral mucosa. A rat esophageal anastomosis model was created, and two dry sheets were applied to cover the anastomotic sites. Anastomotic leakage incidence, burst pressure, histological findings, and collagen contents were compared between the control and dry sheet groups postoperatively. Results: The dry sheet group demonstrated a lower incidence of anastomotic leakage than the control group (control: 64 % vs. dry sheet: 28 % on day 3, control: 57 % vs. dry sheet: 29 % on day 5). Abscess scores at the esophageal anastomotic sites were also lower in the dry sheet group than in the control group on days 3 and 5. Burst pressure was significantly higher in the dry sheet group than in the control group on days 3 and 5. Collagen type I was significantly increased in the dry sheet group compared with that in the control group. Conclusions: Allogeneic dry sheet application improved anastomotic leakage incidence and burst pressure, indicating the usefulness of these sheets in preventing esophageal anastomotic leakage.