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

1、 Assessing the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine study. 评估无管化经皮肾通道使用止血密封胶及其对肾脏的排水和组织学影响的实验猪的研究。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. 为了评估止血密封胶在无管化经皮肾镜的应用过程中对活体猪肾脏排水和组织学的中期影响。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. 双侧经皮进入成立于28个猪的肾单位。在该过程结束时，一个1型可吸收鱼起源的胶原蛋白粉，人纤维蛋白原和凝血

5、酶涂覆海绵或交联的明胶颗粒/局部凝血酶基质被随机放置在肾造口。4个肾造口未填塞止血密封胶，并作为对照组。术后无皮管，输尿管支架或膀胱导管。术后第1， 15， 30和40 天通过CTU来了解肾脏排水情况。在术后40天，杀死所有的猪，并对每个猪的肾脏进行组织学分析。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. 止血密封胶的应用后，发现存在肾脏排水不畅风险。止血密封剂的使用与肾实

7、质显著的组织学病变有关联，而与密封剂类型无关联。无止血密封剂的应用被鉴定为优于其它。没有密封剂的肾造口(对照组)没有相关发病率和更少的组织病理学变化。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. 根据这些实验结果，止血密封剂在无管化PCNL应用中的安全性应该重新评估，不仅注重这些材料的潜在堵塞尿液引流,还取决于它们对肾组织学的影响。进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