Assessing the use of haemostatic sealants in tubeless percutaneous renal access and their effect on課件

1、 Assessing the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine study. 評(píng)估無管化經(jīng)皮腎通道使用止血密封膠及其對(duì)腎臟的排水和組織學(xué)影響的實(shí)驗(yàn)豬的研究。OBJECTIVE To evaluate the mid-term effects of haemostatic sealant application during tubeless percu

2、taneous nephrolithotomy (PCNL) on renal drainage and histology in an in vivo porcine study. 為了評(píng)估止血密封膠在無管化經(jīng)皮腎鏡的應(yīng)用過程中對(duì)活體豬腎臟排水和組織學(xué)的中期影響。MATERIALS AND METHODSBilateral percutaneous access was established in 28 porcine renal units. At the end of the procedure, a type 1 absorbable fish origin collagen pow

3、der, a human fibrinogen- and thrombin-coated sponge or a cross-linked gelatin granule/topical thrombin matrix were randomly placed on the nephrostomy tracts. Four nephrostomy accesses were left intact and served as controls. No percutaneous tube, ureteric stent or bladder catheter was left in place

4、postoperatively. Computed tomography urography on postoperative days 1, 15, 30 and 40 was used to access renal drainage. On postoperative day 40, all animals were killed and both kidneys from each animal were harvested for histological evaluation. 雙側(cè)經(jīng)皮進(jìn)入成立于28個(gè)豬的腎單位。在該過程結(jié)束時(shí)，一個(gè)1型可吸收魚起源的膠原蛋白粉，人纖維蛋白原和凝血

5、酶涂覆海綿或交聯(lián)的明膠顆粒/局部凝血酶基質(zhì)被隨機(jī)放置在腎造口。4個(gè)腎造口未填塞止血密封膠，并作為對(duì)照組。術(shù)后無皮管，輸尿管支架或膀胱導(dǎo)管。術(shù)后第1， 15， 30和40 天通過CTU來了解腎臟排水情況。在術(shù)后40天，殺死所有的豬，并對(duì)每個(gè)豬的腎臟進(jìn)行組織學(xué)分析。RESULTS Evidence of risk for drainage occlusion after sealant application was found. The use of haemostatic sealants was associated with significant histological lesions

6、 in the renal parenchyma, regardless of which sealant was used. No sealant was identified as superior to the others. Nephrostomy tracts that were left without sealant application (control group) were associated with no morbidity and fewer histopathological changes. 止血密封膠的應(yīng)用后，發(fā)現(xiàn)存在腎臟排水不暢風(fēng)險(xiǎn)。止血密封劑的使用與腎實(shí)

7、質(zhì)顯著的組織學(xué)病變有關(guān)聯(lián)，而與密封劑類型無關(guān)聯(lián)。無止血密封劑的應(yīng)用被鑒定為優(yōu)于其它。沒有密封劑的腎造口(對(duì)照組)沒有相關(guān)發(fā)病率和更少的組織病理學(xué)變化。CONCLUSIONS Based on these experimental results, the safety of the application of haemostatic sealants in tubeless PCNL should be reassessed, focusing not only on the potential of such materials to occlude urinary drainage bu

8、t also on their effect on renal histology. Further investigation is considered necessary. 根據(jù)這些實(shí)驗(yàn)結(jié)果，止血密封劑在無管化PCNL應(yīng)用中的安全性應(yīng)該重新評(píng)估，不僅注重這些材料的潛在堵塞尿液引流,還取決于它們對(duì)腎組織學(xué)的影響。進(jìn)一步的研究是必要的。Assessing the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology:

9、an experimental porcine studyBJU InternationalVolume 112, Issue 2, pages E114-E121, 3 APR 2013 DOI: 10.1111/bju.12060http:/ the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine studyBJU InternationalVolume 112

10、, Issue 2, pages E114-E121, 3 APR 2013 DOI: 10.1111/bju.12060http:/ the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine studyBJU InternationalVolume 112, Issue 2, pages E114-E121, 3 APR 2013 DOI: 10.1111/bju.

11、12060http:/ the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine studyBJU InternationalVolume 112, Issue 2, pages E114-E121, 3 APR 2013 DOI: 10.1111/bju.12060http:/ the use of haemostatic sealants in tubeless

12、percutaneous renal access and their effect on renal drainage and histology: an experimental porcine studyBJU InternationalVolume 112, Issue 2, pages E114-E121, 3 APR 2013 DOI: 10.1111/bju.12060http:/ the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine studyBJU InternationalVolume 112, Issue 2, pages E114-E121, 3 APR 2013 DOI: 10.1111/bju.12060http:/ the use of haemostatic sealants in tubeless