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腹腔镜膀胱浆肌层切开术:实验室经验

Laparoscopic bladder seromyotomy: laboratory experience.

作者信息

Figenshau R S, Clayman R V, Klutke C G, McDougall E M, Pearle M S, Moon Y T, Gardner S M, Tiemann D D

机构信息

Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

J Endourol. 1996 Jun;10(3):267-71. doi: 10.1089/end.1996.10.267.

Abstract

Twelve female microminipigs with normal bladder capacity underwent laparoscopic bladder seromyotomy. Three other female microminipigs were added to the study as controls. Urodynamic studies and cystograms were performed preoperatively and at 2 and 4 months after a laparoscopic bladder seromyotomy. Histologic studies of the treated bladders were performed when the animals were euthanized at 4 months. The operation was completed in all 12 test animals. There was no significant difference in bladder capacity or leak-point pressure between the 12 seromyotomy and the 3 control bladders at any time point. Histologically, over the seromyotomy site, the urothelium remained intact; however, the muscularis was attenuated, and a thin layer of fibrotic tissue replaced the normal serosal covering of the bladder. Laparoscopic bladder seromyotomy can be performed reliably in the porcine animal model. Not surprisingly, no significant changes in bladder capacity or bladder compliance were seen in our study of normal bladders. An animal model of a neuropathic contracted bladder is needed to assess more accurately the physiological impact of laparoscopic seromyotomy.

摘要

12只膀胱容量正常的雌性微型猪接受了腹腔镜膀胱浆膜肌层切开术。另外3只雌性微型猪作为对照加入该研究。在术前以及腹腔镜膀胱浆膜肌层切开术后2个月和4个月进行尿动力学研究和膀胱造影。当动物在4个月时安乐死时,对治疗后的膀胱进行组织学研究。所有12只试验动物均完成了手术。在任何时间点,12只接受浆膜肌层切开术的膀胱与3只对照膀胱之间的膀胱容量或漏点压力均无显著差异。组织学上,在浆膜肌层切开部位,尿路上皮保持完整;然而,肌层变薄,一层薄薄的纤维化组织取代了膀胱正常的浆膜覆盖。腹腔镜膀胱浆膜肌层切开术在猪动物模型中可以可靠地进行。不出所料,在我们对正常膀胱的研究中,未观察到膀胱容量或膀胱顺应性有显著变化。需要一个神经源性挛缩膀胱的动物模型来更准确地评估腹腔镜浆膜肌层切开术的生理影响。

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