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采用带血管化囊袋组织预制颊黏膜移植物的管状化尿道重建术在兔模型中的应用。

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model.

机构信息

Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China.

Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

出版信息

Asian J Androl. 2019 Jul-Aug;21(4):381-386. doi: 10.4103/aja.aja_43_19.

DOI:10.4103/aja.aja_43_19
PMID:31267985
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6628739/
Abstract

Tubularized graft urethroplasty fails largely because of inadequate graft take. Prefabrication of buccal mucosa lined flap has theoretical indications for constructing neourethra with an independent blood supply. The efficacy of using a tissue expander capsule as an induced vascular bed to prefabricate an axial vascularized buccal mucosa-lined flap for tubularized urethral reconstruction in a rabbit model was tested. The experiments were performed in three stages. First, silicone tissue expanders were inserted into the groin to induce vascularized capsule pouch formation. Next, buccal mucosa grafts were transplanted to the newly formed capsular tissue supplied by the axial vessel for buccal mucosa-lined flap prefabrication. Then, circumferential urethral defects were created and repaired by buccal mucosa graft (Group 1), capsule flap (Group 2) and prefabricated capsule buccal mucosa composite flap (Group 3). With retrograde urethrography, no rabbits in Group 1 maintained a wide urethral caliber. In Group 2, the discontinued epithelial layer regenerated at 1 month, and the constructed neourethra narrowed even though the lumen surface formed intact urothelial cells at 3 months. In Group 3, buccal mucosa formed the lining in the neourethra and kept a wide urethral caliber for 3 months. The capsule may serve as an induced vascular bed for buccal mucosa-lined flap prefabrication. The prefabricated buccal mucosa-lined flap may serve as a neourethra flap for circumferential urethral replacement.

摘要

管状移植物尿道成形术失败的主要原因是移植物的成活率低。预先制备颊黏膜内衬皮瓣具有为新尿道提供独立血供的理论依据。本研究旨在测试使用组织扩张器囊作为诱导血管床来预先构建轴向血管化颊黏膜内衬皮瓣，以用于兔模型的管状尿道重建。实验分三个阶段进行。首先，将硅酮组织扩张器插入腹股沟以诱导血管化囊袋形成。接下来，将颊黏膜移植物移植到新形成的由轴向血管供应的囊状组织中，以预先构建颊黏膜内衬皮瓣。然后，通过颊黏膜移植物（第 1 组）、囊瓣（第 2 组）和预制囊颊黏膜复合瓣（第 3 组）修复环状尿道缺损。通过逆行尿道造影，第 1 组没有一只兔子保持尿道口径宽阔。第 2 组在 1 个月时上皮层中断的部分再生，尽管在 3 个月时构建的新尿道腔表面形成了完整的尿路上皮细胞，但尿道仍变窄。第 3 组在新尿道中形成了颊黏膜衬里，并且在 3 个月内保持了宽阔的尿道口径。囊状组织可能作为颊黏膜内衬皮瓣预先构建的诱导血管床。预制的颊黏膜内衬皮瓣可用作环状尿道替代的新尿道皮瓣。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/eeff9b904b15/AJA-21-381-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/bdd414cfe348/AJA-21-381-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/5e38876db367/AJA-21-381-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/d97b19106e05/AJA-21-381-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/d8f7acd614ce/AJA-21-381-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/08cf3a27f71b/AJA-21-381-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/eeff9b904b15/AJA-21-381-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/bdd414cfe348/AJA-21-381-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/5e38876db367/AJA-21-381-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/d97b19106e05/AJA-21-381-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/d8f7acd614ce/AJA-21-381-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/08cf3a27f71b/AJA-21-381-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2605/6628739/eeff9b904b15/AJA-21-381-g006.jpg

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