Liatsikos E N, Siablis D, Kalogeropoulou C, Karnabatidis D, Triadopoulos A, Varaki L, Zabakis P, Perimenis P, Barbalias G A
Department of Urology, University of Patras, School of Medicine, Greece.
J Endourol. 2001 Sep;15(7):747-51. doi: 10.1089/08927790152596361.
The purpose of the present study was to compare the standard metal stents with internally and externally coated metal stents in the pig model.
In nine female pigs weighing between 25 and 30 kg, the metal stents were randomly placed in either the right or left ureter, for a total of 18 stented ureters. Six ureters were stented with a Wallstent (Schneider, Zurich, Switzerland), six with a Passager stent (Boston Scientific, Natick, MA, USA), and six with a Corvita endoluminal graft (CEG) (Boston Scientific, Natick, MA, USA). Patency was examined by nephrostotomography 24 hours and 21 days after the initial procedure.
Free flow of urine through the stents into the bladder was revealed in all ureters with the exemption of four cases where a Passager stent migrated into the bladder, jeopardizing ureteral patency. The Wallstent generated mild inflammation with metaplasia of the urothelium; the CEG a more pronounced inflammatory response in the adjacent ureter; and the Passager stent severe inflammatory reaction with necrosis of the urothelium. The sections of the Wallstents revealed the presence of a mild polypoid reaction adherent to the internal surface of the devices. The coated stents showed no tissue ingrowth through the lining material into the ureteral lumen, and thus, the urothelium was compressed beneath the prostheses.
Our experimental results suggest that the standard Wallstent generates less inflammation of the surrounding tissues than coated stents. The coated stents have the advantage of minimal tissue ingrowth but have a tendency to migrate toward the bladder.
本研究旨在比较猪模型中标准金属支架与内外涂层金属支架。
在9只体重25至30千克的雌性猪中，将金属支架随机置于右侧或左侧输尿管，共18条输尿管置入支架。6条输尿管置入Wallstent支架（瑞士苏黎世的施奈德公司生产），6条置入Passager支架（美国马萨诸塞州纳蒂克的波士顿科学公司生产），6条置入Corvita腔内移植物（CEG，美国马萨诸塞州纳蒂克的波士顿科学公司生产）。在初始操作后24小时和21天通过肾造瘘术检查通畅情况。
除4例Passager支架移入膀胱危及输尿管通畅外，所有输尿管均显示尿液通过支架自由流入膀胱。Wallstent支架引起轻度炎症伴尿路上皮化生；CEG在相邻输尿管引起更明显的炎症反应；Passager支架引起严重炎症反应伴尿路上皮坏死。Wallstent支架切片显示装置内表面有轻度息肉样反应。涂层支架未显示组织通过内衬材料长入输尿管腔，因此，尿路上皮在假体下方受到压迫。
我们的实验结果表明，标准的Wallstent支架比涂层支架对周围组织产生的炎症更少。涂层支架具有组织向内生长最少的优点，但有向膀胱迁移的倾向。
