Outcomes of adult urethroplasty with commercially available acellular matrix
Outcomes of adult urethroplasty with commercially available acellular matrix
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DOI：
10.1177/1756287218790370
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发表时间：
2018-11-01
影响因子：
2
通讯作者：
Terlecki, Ryan Patrick
中科院分区：
文献类型：
--
作者：
Pearlman, Amy Marcia;Mujumdar, Vaidehi;Terlecki, Ryan Patrick
背景：复杂性尿道狭窄的重建可能需要移植。颊粘膜移植（BMG）的收获涉及额外的发病率，使现成的选择有吸引力。多种细胞外基质（ECM）已被用于不同程度的成功。我们回顾了MatriStem（ACell，Inc.，哥伦比亚，MD，USA）来评估安全性和临床/组织学结果。关于手术适应症，患者的人口统计学，随后的程序，临床结果，和组织学分析，当存在，collected.Results：8例患者进行尿道重建与ECM。所有修复均作为分期手术进行。采用单独的MatriStem或MatriStem和伴随的BMG进行移植。7例患者（88%）接受了既往内镜干预，5例患者（71%）对既往一次或多次尿道成形术无效。受累节段长度2.5 ~ 15 cm。ECM移植物放置是可行的，并表现出良好的移植物吸收。在接受第二阶段修复的患者（四个8，50%），50%保持通畅，而不需要随后的dilation.Conclusions：使用脱细胞基质移植物在尿道重建似乎是安全可行的。脱细胞基质在移植物吸收和分期修复后的收缩方面与BMG相似。需要进一步研究。
Background: Reconstruction for complex urethral strictures may necessitate grafting. Buccal mucosal graft (BMG) harvest involves additional morbidity, making off-the-shelf' options attractive. Multiple extracellular matrices (ECMs) have been used with varying degrees of success. We reviewed our experience with MatriStem (ACell, Inc., Columbia, MD, USA) to assess safety and clinical/histologic outcomes.Methods: All patients undergoing acellular matrix-based reconstruction were included. Data regarding indications for surgery, patient demographics, subsequent procedures, clinical outcomes, and histologic analysis, when present, were collected.Results: Eight patients undergoing urethral reconstruction with ECM were identified. All repairs were performed as staged procedures. Grafting was performed with either MatriStem alone or MatriStem and concomitant BMG. Seven patients (88%) underwent prior endoscopic intervention and five patients (71%) had failed to respond to one or multiple prior urethroplasties. Length of involved segments ranged from 2.5 to 15 cm. ECM graft placement was feasible and demonstrated excellent graft take. Among patients undergoing second-stage repairs (four of eight, 50%), 50% remained patent without the need for subsequent dilation.Conclusions: Use of acellular matrix grafts in urethral reconstruction appears safe and feasible. Acellular matrix performs similarly to BMG with respect to graft take and contraction following staged repair. Further study is warranted.