Three-dimensionally printed surface features to anchor endoluminal spring for distraction enterogenesis.
Three-dimensionally printed surface features to anchor endoluminal spring for distraction enterogenesis.
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DOI：
10.1371/journal.pone.0200529
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Dunn JCY
中科院分区：
文献类型：
--
作者：
Huynh N;Dubrovsky G;Rouch JD;Scott A;Chiang E;Nguyen T;Wu BM;Shekherdimian S;Krummel TM;Dunn JCY
弹簧介导的牵张肠生成为短肠综合征(SBS)的一种新的治疗方法。以前的方法受到多次手术恢复肠道连续性的限制。纯粹的腔内装置需要一段时间的肠道附着才能发生肠道。本研究的目的是对该装置进行改进，以防止猪模型中的早春迁徙。在幼年小型尤卡坦猪中创建了两个模型，用于放置三维打印弹簧。(1)双侧Roux肢体空肠Roux-en-y吻合2例。在一个Roux肢体上放置一个具有双向钩状表面特征的弹簧，在另一个Roux肢体上放置一个表面光滑的弹簧。(2)不连续模型将钩状表面弹簧和光滑表面弹簧直接放置在肠道连续性内。术后2~4周取肠，每周拍片评价弹簧位置。在两种猪模型中，表面光滑的弹簧在放置后1-3周内迁移。具有双向钩状表面特征的弹簧固定在肠道上长达4周，没有迁移。组织学上，与正常空肠相比，空肠结构显示隐窝深度和肌层厚度显著增加。弹簧上的双向特征防止了管腔内弹簧的过早迁移。这些新颖的弹簧锚不需要任何缝线就可以放置在管腔内。这种方法可能导致对SBS患者进行内窥镜下装置的放置。
Spring-mediated distraction enterogenesis has been studied as a novel treatment for short bowel syndrome (SBS). Previous approaches are limited by multiple surgeries to restore intestinal continuity. Purely endoluminal devices require a period of intestinal attachment for enterogenesis. The purpose of this study is to modify the device to prevent premature spring migration in a porcine model. Two models were created in juvenile mini-Yucatan pigs for the placement of three-dimensionally printed springs. (1) Two Roux-en-y jejunojenostomies with two Roux limbs were made. A spring with bidirectional hooked surface features was placed in one Roux limb and a spring with smooth surface was placed in the other Roux limb. (2) The in-continuity model had both hooked and smooth surface springs placed directly in intestinal continuity. Spring location was evaluated by weekly radiographs, and the intestine was retrieved after 2 to 4 weeks. Springs with smooth surfaces migrated between 1 to 3 weeks after placement in both porcine models. Springs with bidirectional hooked surface features were anchored to the intestine for up to 4 weeks without migration. Histologically, the jejunal architecture showed significantly increased crypt depth and muscularis thickness compared to normal jejunum. Bidirectional features printed on springs prevented the premature migration of endoluminal springs. These novel spring anchors allowed for their endoluminal placement without any sutures. This approach may lead to the endoscopic placement of the device for patients with SBS.
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影响因子：
2.5
作者：
Han SH;Lee JH
通讯作者：
Lee JH
影响因子：
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作者：
Scott A;Rouch JD;Jabaji Z;Khalil HA;Solorzano S;Lewis M;Martín MG;Stelzner MG;Dunn JC
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