Tissue engineering represents a promising and innovative strategy for the treatment of complex congenital and acquired oesophageal disorders, particularly in patients for whom conventional therapies have failed or current options for organ replacement remain inadequate. Current approaches have explored the use of synthetic and biological scaffolds, cell-based therapies, or combinations of both to promote tissue regeneration and restoration of function. Increasing evidence suggests that, in order to achieve a functional oesophagus, hybrid strategies incorporating exogenous cell delivery may further enhance regenerative outcomes while simultaneously modulating inflammatory responses. Importantly, the feasibility and effectiveness of oesophageal tissue engineering are strongly influenced by the extent and depth of the defect. Encouraging results achieved in partial-thickness defects and patch repair models have supported early clinical translation. In contrast, reconstruction of full-thickness, circumferential oesophageal defects, that are relevant to oesophageal atresia, defects remain a major unresolved challenge, primarily due to complications such as luminal stenosis, anastomotic leakage, and incomplete regeneration of organised muscular and neuromuscular structures. Consequently, further preclinical and translational research is required to develop safe, reproducible, and standardised strategies for circumferential oesophageal replacement. Such efforts must be supported by transparent and comprehensive reporting of experimental outcomes to facilitate meaningful comparison and clinical translation. In this review, we summarise current oesophageal tissue-engineering strategies relevant to oesophageal atresia, critically evaluate the available evidence, and discuss future directions in the field.
Gazzaneo et al. (Thu,) studied this question.