Bochner B H, Stein J P, Ginsberg D A, Kurzrock E, Figueroa A, Skinner D G
Department of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA.
J Urol. 1998 Jul;160(1):112-5. doi: 10.1016/s0022-5347(01)63049-0.
We evaluate the fluoroscopic and urodynamic performance of a new serosal lined antireflux continence valve (T pouch valve) using an in vivo animal model.
Intestinal reservoirs were constructed using an in vivo pig model. Multiple serosal lined valves of varying diameters and tunnel lengths were evaluated in the acute (immediately after construction) and chronic (4 weeks postoperatively) settings. Video fluorourodynamic evaluations were performed to identify valve leak point pressures and optimal tunnel length-to-luminal diameter ratios.
Four serosal lined valves tapered to a diameter of 18 and 30F in 1 and 2 cm. tunnels were evaluated. Immediately following construction of the valves no leakage was observed during reservoir filling (maximal pressure 50 cm. water) or external compression maneuvers to simulate a Valsalva maneuver (maximal intra-reservoir pressure 100 cm. water). Identical fluorourodynamic studies performed after a 4-week recuperation demonstrated leakage through the 30F, 1 cm. tunnel valve during reservoir filling (intra-reservoir pressure 19 cm. water). Increasing the tunnel length of the 30F system to 2 cm. (tunnel length-to-luminal diameter ratio 2:1) eliminated all evidence of valve leakage up to a maximal intra-reservoir pressure of 100 cm. water.
These studies demonstrate the urodynamic characteristics of a new serosal lined valve. This easily constructed mechanism serves as a reliable antireflux (afferent) or continence (efferent) system.
我们使用体内动物模型评估一种新型浆膜内衬抗反流控尿瓣膜（T形袋瓣膜）的荧光透视和尿动力学性能。
使用体内猪模型构建肠道储尿囊。在急性（构建后立即）和慢性（术后4周）情况下评估多个不同直径和隧道长度的浆膜内衬瓣膜。进行视频荧光尿动力学评估以确定瓣膜泄漏点压力和最佳隧道长度与管腔直径之比。
评估了四个浆膜内衬瓣膜，其在1厘米和2厘米的隧道中逐渐变细至直径18F和30F。在瓣膜构建后立即进行储尿囊充盈（最大压力50厘米水柱）或模拟瓦尔萨尔瓦动作的外部压迫动作（储尿囊内最大压力100厘米水柱）时未观察到泄漏。在4周恢复后进行的相同荧光尿动力学研究表明，在储尿囊充盈期间（储尿囊内压力19厘米水柱），30F、1厘米隧道瓣膜出现泄漏。将30F系统的隧道长度增加到2厘米（隧道长度与管腔直径之比为2:1）消除了在储尿囊内最大压力达到100厘米水柱之前的所有瓣膜泄漏迹象。
这些研究证明了一种新型浆膜内衬瓣膜的尿动力学特性。这种易于构建的机制可作为可靠的抗反流（输入）或控尿（输出）系统。
