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一种用于辅助开发治疗结肠狭窄新型支架的新型结肠狭窄动物模型。

A novel animal model of colonic stenosis to aid the development of new stents for colon strictures.

作者信息

Hiratsuka Takahiro, Inomata Masafumi

机构信息

Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Oita, 879-5593, Japan.

出版信息

Surg Endosc. 2022 May;36(5):3152-3159. doi: 10.1007/s00464-021-08618-4. Epub 2021 Jun 22.

Abstract

BACKGROUND

The incidence of colonic stenosis, primarily caused by colon cancer and Crohn's disease, is increasing each year. The development of safer stents for colonic stenosis is required because perforation associated with cancer stent placement worsens the prognosis and stent placement for anastomotic stenosis due to Crohn's disease or colectomy is not first choice due to the high migration rate. The wall of the large intestine where the stent is inserted receives the complex forces from the peristaltic movement of the large intestine and stool in addition to the reaction tension of the stent, causing perforation and migration. Animal models may help develop new and safe stents, but no animal model closely reproduces the condition of human colonic stenosis. Herein, we present a novel animal model of colonic stenosis, which closely replicates the human colonic size.

METHODS

The artificial colonic stenosis model was developed by wrapping the porcine colon with a silicone sheet after laparotomy. The usefulness of the model was evaluated by investigating the availability of endoscopic stent placement, morphological maintenance of colonic stenosis, adverse effects on pigs, and modeling time. The first three and the last three modeling times were analyzed using Student's t-test.

RESULTS

Endoscopic stent placement was performed in all cases without intraoperative complications. There were no postoperative model complications or deaths. Adhesions to the surrounding tissue in the abdominal cavity of the artificial colon stenosis were slight. The morphology of the isolated artificial stenoses was completely maintained, and no necrosis or perforation was observed.

CONCLUSIONS

We developed a novel and feasible animal model of colonic stenosis using pigs. We believe that this animal model will be useful for developing a safer stent for obstruction caused by benign diseases and colon cancer.

摘要

背景

结肠狭窄的发病率逐年上升,其主要病因是结肠癌和克罗恩病。由于癌症支架置入相关的穿孔会使预后恶化,且因克罗恩病或结肠切除术导致的吻合口狭窄进行支架置入时,由于迁移率高并非首选,因此需要研发更安全的结肠狭窄支架。插入支架的大肠壁除了受到支架的反应张力外,还会受到大肠蠕动和粪便的复杂作用力,从而导致穿孔和迁移。动物模型可能有助于开发新的安全支架,但尚无动物模型能紧密再现人类结肠狭窄的情况。在此,我们提出一种新型的结肠狭窄动物模型,其能紧密复制人类结肠大小。

方法

通过剖腹术后用硅胶片包裹猪结肠建立人工结肠狭窄模型。通过研究内镜下支架置入的可行性、结肠狭窄的形态维持、对猪的不良反应以及建模时间来评估该模型的实用性。使用学生t检验分析前三次和最后三次建模时间。

结果

所有病例均成功进行了内镜下支架置入,术中无并发症。术后无模型并发症或死亡。人工结肠狭窄腹腔内与周围组织的粘连轻微。孤立的人工狭窄形态完全维持,未观察到坏死或穿孔。

结论

我们利用猪建立了一种新型且可行的结肠狭窄动物模型。我们相信该动物模型将有助于开发一种更安全的支架,用于治疗由良性疾病和结肠癌引起的梗阻。

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