Chen Y J, Liu W, Xi H B, Yu Y, Hu J P, Deng J, Lin L H, Li C, Wang G X, Fu B, Zhou X C
Nanchang University Medical College, Nanchang 330006, China.
Department of Urology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Zhonghua Yi Xue Za Zhi. 2022 Jun 14;102(22):1660-1665. doi: 10.3760/cma.j.cn112137-20211027-02380.
To investigate the feasibility of using a porcine fibrin sealant to wrap and remove kidney calculi fragments through an isolated porcine kidney model. In the isolated porcine kidney stone model (implanted with 100 mg, air dried, ≤1 mm human stone fragments, =6;implanted with 100 mg, air dried, ≤3 mm human stone fragments, =6), the ureteral soft mirror combined with the 12/14Fr UAS was used to test the effect of stone extraction using only two stone extraction methods: basket extraction (control group, ≤1 mm stone fragments, =3; ≤3 mm stone fragments, =3) and basket-sealant extraction (test group, ≤1 mm stone fragments, =3; ≤3 mm stone fragments, =3). Compare the stone removal rate and operation time of the two stone retrieval methods. The sealant was put into urine of normal human and observed. Porcine Fibrin Sealant can form a gel in saline and urine and adhere and wrap stone fragments. The time of procedures of test (basket-sealant) and control (basket) group in kidneys implanted with ≤ 1 mm stone fragments were (14.0±4.2) and (29.0±0.7)min (<0.05) stone clearance rates were (90.9±1.4)% and (48.4±15.7)% (<0.05), respectively. In kidneys implanted with ≤ 3 mm fragments, time of procedures were (12.8±4.0) and (30.0±0)min (<0.05) Stone clearance rates were (91.1±5.0)% and (20.7±8.0)% (<0.05). The Sealant dissolves by itself in normal human urine and normal saline at 37 ℃ for 24 hours. The appropriate concentration of Porcine Fibrin Sealant assisted stone retrieval may become a new method for removing small stone fragments in retrograde intrarenal surgery.
通过孤立猪肾模型研究使用猪纤维蛋白密封剂包裹并取出肾结石碎片的可行性。在孤立猪肾结石模型（植入100mg、风干、≤1mm人结石碎片，n = 6；植入100mg、风干、≤3mm人结石碎片，n = 6）中，输尿管软镜联合12/14Fr输尿管通路鞘，仅采用两种取石方法测试取石效果：网篮取石（对照组，≤1mm结石碎片，n = 3；≤3mm结石碎片，n = 3）和网篮 - 密封剂取石（试验组，≤1mm结石碎片，n = 3；≤3mm结石碎片，n = 3）。比较两种取石方法的结石清除率和手术时间。将密封剂放入正常人尿液中观察。猪纤维蛋白密封剂可在盐水和尿液中形成凝胶并黏附包裹结石碎片。在植入≤1mm结石碎片的肾脏中，试验组（网篮 - 密封剂）和对照组（网篮）的手术时间分别为(14.0±4.2)和(29.0±0.7)分钟（P<0.05），结石清除率分别为(90.9±1.4)%和(48.4±15.7)%（P<0.05）。在植入≤3mm结石碎片的肾脏中，手术时间分别为(12.8±4.0)和(30.0±0)分钟（P<0.05），结石清除率分别为(91.1±5.0)%和(20.7±8.0)%（P<0.05）。密封剂在37℃正常人尿液和生理盐水中24小时可自行溶解。适当浓度的猪纤维蛋白密封剂辅助取石可能成为逆行肾内手术中取出小结石碎片的一种新方法。
