Inhibition of hyperplasia during the implantation of the puborectalis-like artificial anal sphincter
Inhibition of hyperplasia during the implantation of the puborectalis-like artificial anal sphincter
复制标题
耻骨直肠肌样人工肛门括约肌植入过程中增生的抑制
DOI：
10.1177/0391398819900187
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Hua Fangfang
中科院分区：
文献类型：
--
作者：
Zhou Zerun;Yan Guozhen;Wang Zhiwu;Jiang Pingping;Yao Shengjian;Ding Zifan;Hua Fangfang
目的：本研究旨在通过抑制耻骨直肠型人工肛门括约肌植入过程中的增生来延长其植入寿命。方法：在耻骨直肠型人工肛门括约肌内设计了一种新的传动结构，即使假体括约肌周围出现增生，也能产生足够的扭矩来维持粪便。在假体括约肌上加一个外壳，以减缓外壳侧增生的发生。用医用钛合金替代尼龙-12假体括约肌，用聚醚醚酮代替尼龙-12构建耻骨直肠型人工肛门括约肌系统的电源单元。在过去的2个 年中，用10头PA MA仔猪、1头家猪和1只比格犬进行了活体实验，以评估本研究中提出的所有方法。结果：与原有固定轴齿轮传动的假体括约肌相比，新的传动结构配备了行星轮系，使假体括约肌的输出扭矩增加53%，但电机的大小和类型与以前相同，种植寿命提高了56%。在更换尼龙-12后，医用钛合金制成的新型假体括约肌成功地将植入寿命延长了83%。此外，当在假体括约肌上增加一个外壳时，寿命增加了143%。更换电源单元材料后，聚醚醚酮使电源单元周围的增生率显著降低44%。综合改进后，耻骨直肠型人工肛门括约肌在体内的最长植入寿命为7 月10 d，提高了249%。结论：所有方法均能有效延长耻骨直肠型人工肛门括约肌的植入寿命。在所提出的方法中，最有效的是在耻骨直肠样人工肛门括约肌上添加外壳。最不有效的方法是改进传动结构。医用钛合金和聚醚醚酮是尼龙-12的良好替代品，延长了植入寿命，并取得了适度的改善。
Objectives: This study aims to extend the implantation lifetime of the puborectalis-like artificial anal sphincter by inhibiting the occurrence of hyperplasia following the implantation process. Method: A new transmission structure was designed inside the puborectalis-like artificial anal sphincter to generate an adequate torque to maintain the feces, even if hyperplasia developed around the prosthetic sphincter. An outer shell was added to the prosthetic sphincter to decelerate the occurrence of hyperplasia on the outer shell side. Medical titanium alloy was tested to replace the nylon-12 prosthetic sphincter, while polyetheretherketone was used for the construction of the power supply unit in the puborectalis-like artificial anal sphincter system instead of nylon-12. In vivo experiments were conducted to evaluate all the methods presented in this study with 10 Pa Ma piglets, 1 domestic pig, and 1 beagle dog during the past 2 years. Results: Compared with the previous prosthetic sphincter that was equipped with a fixed-axle gear transmission, the new transmission structure is equipped with a planet-gear train managed to generate a prosthetic sphincter output with a 53% larger torque but with the same size and type of motor as that used previously and increase the implantation lifetime by 56%. After the replacement of the nylon-12, the new prosthetic sphincter made of medical titanium alloy succeeded in extending the implanted lifetime by 83%. In addition, the lifetime was increased by 143%, when an outer shell was added to the prosthetic sphincter. Polyetheretherketone significantly decreased the growth rate of hyperplasia around the power supply unit by 44% after the replacement of the power supply unit material. After the combination of all the improvements, the longest implantation lifetime of the puborectalis-like artificial anal sphincter during the in vivo experiments was 7 months and 10 days, which reflected an improvement of 249%. Conclusion: All methods posted in this study were evaluated to be effective to prolong the implantation lifetime of the puborectalis-like artificial anal sphincter. Among the methods proposed, the most effective was the addition of the outer shell to the puborectalis-like artificial anal sphincter. The least effective method was the improvement of the transmission structure. Medical titanium alloy and polyetheretherketone were good replacements for nylon-12 that managed to extend the implantation lifetime and yield a moderate improvement.
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影响因子：
4
作者：
Jerez-Roig, Javier;Souza, Dyego L. B.;Lima, Kenio C.
通讯作者：
Lima, Kenio C.
影响因子：
2.4
作者：
H. Schrag;O. Ruthmann;A. Doll;F. Goldschmidtböing;P. Woias;U. Hopt
通讯作者：
H. Schrag;O. Ruthmann;A. Doll;F. Goldschmidtböing;P. Woias;U. Hopt
影响因子：
3.9
作者：
Boyle, Derek J.;Knowles, Charles H.;Gill, Kathryn A.
通讯作者：
Gill, Kathryn A.
影响因子：
3.1
作者：
Terpilowski, Konrad;Wiacek, Agnieszka Ewa;Jurak, Malgorzata
通讯作者：
Jurak, Malgorzata
影响因子：
1.7
作者：
Yun Luo;M. Higa;S. Amae;T. Takagi;T. Yambe;Takeshi Okuyama;Hiromu Tanaka;Y. Kakubari;H. Matsuki-H
通讯作者：
Yun Luo;M. Higa;S. Amae;T. Takagi;T. Yambe;Takeshi Okuyama;Hiromu Tanaka;Y. Kakubari;H. Matsuki-H