Xie Hua, Shaffer Brian S, Prahl Scott A, Gregory Kenton W
Oregon Medical Laser Center, Providence St. Vincent Medical Center, Portland, Oregon 97225, USA.
Lasers Surg Med. 2003;32(4):294-8. doi: 10.1002/lsm.10164.
We compared ureteral anastomosis using a laser and intraluminal albumin stent with both conventional suturing and laser soldering techniques.
STUDY DESIGN/MATERIALS AND METHODS: Twelve pigs underwent bilateral ureteral anastomoses (N = 24) using one of the three anastomotic methods: (1) laser welding with intraluminal albumin stent (N = 11); (2) with albumin solder (N = 8); and (3) conventional suturing (N = 5). Operative parameters, leakage rate, intrapelvic perfusion pressure, urography, and histology of the anastomoses were examined.
Operative time for ureteral anastomosis in the stent and solder groups were significantly shorter than the suture group (means 370 seconds and 360 vs. 710 seconds, both P = 0.02). Leakage rate of the anastomoses was lower in the stent group (9%, 1/11) as compared to the solder group (25%, 2/8). The Whitaker test showed that the intrapelvic perfusion pressure elevated gradually after anastomosis and significantly increased at 4 weeks postoperatively in all three methods. Various degrees of hydronephrosis were also noticed in three groups after 4 weeks of surgery.
Use of the intraluminal albumin stent increased the reliability of laser welding for ureteral anastomosis. The clinical significance of using this technique should be investigated further.
我们比较了使用激光和腔内白蛋白支架进行输尿管吻合术与传统缝合及激光焊接技术的效果。
研究设计/材料与方法：12头猪接受双侧输尿管吻合术（N = 24），采用三种吻合方法之一：（1）使用腔内白蛋白支架的激光焊接（N = 11）；（2）使用白蛋白焊料（N = 8）；（3）传统缝合（N = 5）。检查手术参数、漏液率、肾盂内灌注压力、尿路造影及吻合口组织学情况。
支架组和焊料组输尿管吻合术的手术时间明显短于缝合组（平均370秒和360秒对710秒，P均 = 0.02）。支架组吻合口漏液率（9%，1/11）低于焊料组（25%，2/8）。惠特克试验表明，三种方法吻合术后肾盂内灌注压力均逐渐升高，术后4周显著增加。术后4周，三组均出现不同程度的肾积水。
腔内白蛋白支架的使用提高了输尿管吻合术激光焊接的可靠性。该技术的临床意义有待进一步研究。
