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经动脉前列腺栓塞术:在犬模型中的初步经验。

Transarterial prostatic embolization: initial experience in a canine model.

机构信息

Endoluminal Therapy and Diagnosis Department, Jesús Usón Minimally Invasive Surgery Centre, Carretera N-521, km 41.8, 10071 Cáceres, Spain.

出版信息

AJR Am J Roentgenol. 2011 Aug;197(2):495-501. doi: 10.2214/AJR.10.5947.

Abstract

OBJECTIVE

The purpose of this study was to prospectively evaluate pathologic responses to transarterial prostatic embolization and its technical safety in a canine model.

MATERIALS AND METHODS

Ten adult male beagle dogs were surgically castrated and given hormonal therapy for 4 months to induce prostatic hyperplasia. After three months of hormonal therapy, the dogs were randomly assigned to a transarterial prostatic embolization group (n = 7) or a control group (n = 3). Dogs in the transarterial prostatic embolization group were subjected to embolization with microspheres 300-500 μm in diameter. Four months after the study was begun, all dogs were sacrificed for pathologic study. Transrectal ultrasound and MRI were performed to evaluate pathologic responses. The data on prostate size acquired with transrectal ultrasound were processed for statistical analysis by paired Student t test.

RESULTS

The canine prostatic hyperplasia model was successfully established in 10 dogs. The increase in mean prostate size being as great as 572% after 3 months of hormonal therapy. An intraprostatic cavity was detected 1 month after transarterial prostatic embolization in all seven dogs. Four dogs had significant shrinkage of the prostate, and the other three had an increase in prostate size. Imaging examinations and necropsy revealed a huge cavity occupying almost the entire prostate in the three dogs with increased prostate size. No complications associated with transarterial prostatic embolization were encountered.

CONCLUSION

Transarterial prostatic embolization is a safe procedure that can induce prostatic infarction and ablate the prostate. The findings suggest the procedure has potential clinical applications in the care of patients with benign prostatic hyperplasia.

摘要

目的

本研究旨在前瞻性评估经动脉前列腺栓塞术的病理反应及其在犬模型中的技术安全性。

材料与方法

10 只成年雄性比格犬接受了手术去势和激素治疗 4 个月,以诱导前列腺增生。在激素治疗 3 个月后,将这些犬随机分为经动脉前列腺栓塞组(n=7)或对照组(n=3)。经动脉前列腺栓塞组的犬接受 300-500μm 微球栓塞。研究开始后 4 个月,所有犬均被处死进行病理研究。通过直肠超声和 MRI 评估病理反应。通过配对 Student t 检验对直肠超声获得的前列腺大小数据进行统计分析。

结果

10 只犬成功建立了犬前列腺增生模型。经过 3 个月的激素治疗,平均前列腺大小增加了 572%。在所有 7 只犬中,经动脉前列腺栓塞后 1 个月均检测到前列腺内腔。4 只犬的前列腺明显缩小,另外 3 只犬的前列腺体积增大。影像学检查和尸检显示,在前列腺体积增大的 3 只犬中,巨大的腔占据了整个前列腺的几乎全部。没有与经动脉前列腺栓塞相关的并发症。

结论

经动脉前列腺栓塞是一种安全的手术方法,可引起前列腺梗死和消融前列腺。这些发现表明该手术在治疗良性前列腺增生患者方面具有潜在的临床应用价值。

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