Department of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Kobe, Japan.
Department of Urology, Hiroshima University Graduate School of Medicine, Hiroshima, Japan.
World J Urol. 2023 Apr;41(4):1181-1186. doi: 10.1007/s00345-023-04342-x. Epub 2023 Mar 16.
Non-absorbable clips are widely used in urologic surgery and they may come in contact with an open urinary tract intraoperatively. As a result, stray clips in the urinary tract and associated intractable infections have been reported. We developed a bioabsorbable metal and evaluated whether it would dissolve if it strayed into the urinary tract.
We prepared four types of alloys mainly comprising zinc (Zn) with small amounts of magnesium (Mg) and strontium (Sr), and the biological effects, degradability, strength, and ductility were investigated. Each alloy was implanted in the bladder of five rats for 4, 8, and 12 weeks. The alloys were removed and evaluated for degradability, stone adhesion, and tissue changes. The Zn-Mg-Sr alloy had degradability and no stone adhesion in the rat experiments, and it was implanted in the bladders of five pigs for 24 weeks. The Mg and Zn levels in the blood were measured, and staple changes were confirmed by cystoscopy.
Zn-Mg-Sr alloys showed the best degradability of 6.51% at 12 weeks. In pig experiments, the degradation rate was 3.72% at 24 weeks. None of the pigs had changes in the Zn or Mg concentrations in the blood. Overall, the bladder incision was healed and the gross pathology showed wound healing.
The Zn-Mg-Sr alloys were safely used in animal experiments. Furthermore, the alloys are easy to process and can be formed into various shapes, such as staples, making them useful in robotic surgery.
不可吸收夹在泌尿科手术中被广泛应用，术中可能会接触到开放的尿路。因此，有报道称在尿路中出现了游离夹和相关的难治性感染。我们开发了一种可吸收的金属夹，并评估其如果进入尿路是否会溶解。
我们制备了四种主要由锌（Zn）与少量镁（Mg）和锶（Sr）组成的合金，并研究了它们的生物效应、降解性、强度和延展性。将每种合金植入五只大鼠的膀胱中 4、8 和 12 周。取出合金，评估降解性、结石附着和组织变化。在大鼠实验中，Zn-Mg-Sr 合金具有降解性且无结石附着，在五头猪的膀胱中植入 24 周。测量血液中的镁和锌水平，并通过膀胱镜检查确认吻合钉的变化。
Zn-Mg-Sr 合金在 12 周时的降解率最佳，为 6.51%。在猪实验中，24 周时的降解率为 3.72%。所有猪的血液中锌和镁浓度均无变化。总的来说，膀胱切口愈合，大体病理学显示伤口愈合。
Zn-Mg-Sr 合金在动物实验中安全使用。此外，这些合金易于加工，可以形成各种形状，如吻合钉，在机器人手术中很有用。
