一种用于治疗输尿管狭窄疾病的改良型可生物降解网状输尿管支架。
A modified biodegradable mesh ureteral stent for treating ureteral stricture disease.
作者信息
Wang Yichun, Ren Xiaohan, Ji Chengjian, Zhong Da, Wei Xiyi, Zhu Zheng, Zhou Xuan, Zhang Xi, Wang Shuai, Qin Chao, Song Ninghong
机构信息
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
出版信息
Acta Biomater. 2023 Jan 1;155:347-358. doi: 10.1016/j.actbio.2022.11.022. Epub 2022 Nov 17.
Ureteral stricture disease (USD) is a common urologic condition. Patients with ureteral stricture disease may suffer from ipsilateral flank pain, nausea, urinary calculi, infection, and impaired renal function. The treatments of USD include surgery, followed by implantation of the ureteral stent to aid the drainage of the urine. The traditional ureteral stent may sometimes cause urological infection, encrustation, and discomfort. To decrease the complication of the ureteral stent, we modified the structure and material based on the traditional ureteral stent. The traditional nondegradable Double-J shape tubular ureteral stent was turned into the biodegradable mesh ureteral stent. The modified mesh ureteral stent and Double-J ureteral stent were inserted into the ureters of the USD animals, respectively. The results of the gross morphology, serology, urinalysis, histology, microstructure, et al. demonstrated that modified mesh ureteral stent has a favorable ability in supporting the ureter and has no effect on cell proliferation, migration, apoptosis, and cell cycle of the human uroepithelial cells. The mesh ureteral stent could relieve ureter obstruction and can be slowly biodegraded after 3-5 months of implantation without the need for a second surgery to remove the stent. Compared to the Double-J ureteral stent, the modified mesh ureteral stent has a lower rate of urinary tract infection and less encrustation. It is expected to be an alternative treatment approach for USD. However, due to the limited number of animals and clinical data, further study focused on the application value in clinical practice are essential. STATEMENT OF SIGNIFICANCE: This study demonstrates: 1. A modified biodegradable mesh ureteral stent; 2. Without the need for a second surgery to remove the stent; 3. A lower rate of urinary tract infection and less encrustation than a double-J ureteral stent; 4. An alternative treatment approach for USD.
输尿管狭窄疾病(USD)是一种常见的泌尿系统疾病。患有输尿管狭窄疾病的患者可能会出现同侧胁腹疼痛、恶心、尿路结石、感染以及肾功能受损。USD的治疗方法包括手术,随后植入输尿管支架以辅助尿液引流。传统的输尿管支架有时可能会导致泌尿系统感染、结垢和不适。为了减少输尿管支架的并发症,我们在传统输尿管支架的基础上对其结构和材料进行了改进。将传统的不可降解双J形管状输尿管支架转变为可生物降解的网状输尿管支架。分别将改良后的网状输尿管支架和双J输尿管支架植入USD动物的输尿管中。大体形态学、血清学、尿液分析、组织学、微观结构等结果表明,改良后的网状输尿管支架在支撑输尿管方面具有良好的能力,并且对人尿路上皮细胞的增殖、迁移、凋亡和细胞周期没有影响。网状输尿管支架可以缓解输尿管梗阻,植入3至5个月后可缓慢生物降解,无需二次手术取出支架。与双J输尿管支架相比,改良后的网状输尿管支架尿路感染率更低,结垢更少。它有望成为USD的一种替代治疗方法。然而,由于动物数量和临床数据有限,进一步关注其在临床实践中的应用价值的研究至关重要。重要意义声明:本研究表明:1. 一种改良的可生物降解网状输尿管支架;2. 无需二次手术取出支架;3. 与双J输尿管支架相比,尿路感染率更低,结垢更少;4. USD的一种替代治疗方法。