Department of Urology, Singapore General Hospital, Singapore, 169608, Singapore.
, EAU 2023, Milan, Italy.
World J Urol. 2024 Jul 24;42(1):437. doi: 10.1007/s00345-024-05157-0.
Stents with anti-reflux properties have been previously described in various studies but not widely adopted. We designed, constructed and tested a novel umbrella-looking anti-reflux skirt on a double J stent at the level of the ureteral orifice in a previous ex-vivo study. This study serves as a proof of concept of testing this prototype in a porcine model.
3 Yorkshire-Landrace pigs were put under general anaesthesia. Conventional bilateral retrograde stenting with white-colored double-J stents were performed. Deployment of anti-reflux skirt was performed unilaterally. Capsaicin mixed with methylene blue and saline were instilled in the bladder. Both stents were removed and methylene blue stain were inspected to assess the level of reflux. Bilateral stenting was performed again and stents/skirt prototype were left in-situ for 1 week. The procedure was repeated on Day 7 to re-test the anti-reflux property of the prototype after ureteral dilatation.
Intraluminal reflux was evident, with methylene blue stain seen on the inner surface of the stents. Extraluminal reflux was proved with blue stain seen on the outer surface of the stents, both in undilated and dilated ureters. Study also proved the anti-reflux property of the skirt as the blue stain didn't go beyond the skirt, whereas the contralateral stent was stained up to proximal ureter.
In this porcine in-vivo study, we elucidated that reflux occurred were both intraluminal and extraluminally. As a proof of concept, it also showed the anti-reflux property of a novel ureteral skirt.
在之前的研究中，已有研究描述了具有抗反流特性的支架，但并未得到广泛应用。我们在之前的一项离体研究中，在输尿管口水平的双 J 支架上设计、构建并测试了一种新型伞状抗反流裙。本研究旨在通过猪模型来验证该原型的概念验证。
3 头约克夏-兰利猪接受全身麻醉。常规行双侧逆行置管术，使用白色双 J 支架。单侧行抗反流裙展开。向膀胱内注入辣椒素混合亚甲蓝和生理盐水。取出双支架并检查亚甲蓝染色，以评估反流程度。再次行双侧置管术，将支架/裙原型原位保留 1 周。在第 7 天重复该程序，在输尿管扩张后重新测试原型的抗反流性能。
可见腔内反流，支架内表面可见亚甲蓝染色。通过可见支架外表面的蓝色染色证实了腔外反流，在未扩张和扩张的输尿管中均可见。研究还证明了裙的抗反流特性，因为蓝色染色没有超出裙边，而对侧支架染色至近端输尿管。
在这项猪体内研究中，我们阐明了反流既发生在腔内又发生在腔外。作为概念验证，它还展示了一种新型输尿管裙的抗反流特性。
