Comparative evaluation of tissue damage induced by ultrasound and impact dual-mode endoscopic lithotripsy versus conventional single-mode ultrasound lithotripsy
Comparative evaluation of tissue damage induced by ultrasound and impact dual-mode endoscopic lithotripsy versus conventional single-mode ultrasound lithotripsy
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DOI：
10.1007/s00345-019-02747-1
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发表时间：
2020-04-01
影响因子：
3.4
通讯作者：
Bader, Markus Juergen
中科院分区：
文献类型：
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作者：
Khoder, Wael;Strittmatter, Frank;Bader, Markus Juergen
目的在动物体内模型上比较研究三种不同的内窥镜碎石装置（包括一种新型的单探头/双能量碎石器）的组织安全性。将Swiss LithoClast Trilogy与Storz Calcuson和Swiss LithoClast Vario进行了比较。安全性测试模拟了碎石机探头与尿道之间的意外直接接触，这可能发生在碎石术期间从结石上滑落或钻穿结石时。安全性测试包括每件器械的最小（1.5 mm）和最大（3.3/3.4 mm）穿刺针直径。方法在9只猪（每种器械3只动物）中进行试验。将膀胱组织暴露于最大功率下的碎石机探头直接接触10 s，以产生可见的组织损伤。急性组织创伤采用简化的评分模型进行评价，该模型描述了组织学检查预期的膀胱壁损伤。7天后，处死所有动物，进行尸检并进行尸检检查。对于显微组织病理学特征的组间比较，使用卡方检验。p值< 0.05被认为具有统计学显著性。结果无论使用哪种碎石机，均未观察到全身毒性反应。在组织学上，在膀胱粘膜上观察到正常持续愈合的迹象。考虑到两组之间的上皮变化（p = 0.360）、白细胞浸润（p = 0.123）、血管充血（p = 0.929）和水肿（p = 1.0），组织学结果无显著差异。结论本研究的结果表明，所有碎石器械的安全性相当。
Objective The aim of our study was to perform comparative investigation of the tissue safety of three different endoscopic lithotripter devices including a new single-probe/dual-energy lithotripter in an in vivo animal model. The Swiss LithoClast Trilogy was compared to the Storz Calcuson and the Swiss LithoClast Vario. The safety test simulated the accidental direct contact between lithotripter probes and the urothelium, which can occur when sliding off a stone or drilling through a calculus during lithotripsy. The safety test included a smallest (1.5 mm) and largest (3.3/3.4 mm) probe diameter per device. Methods Testing was performed in nine pigs (three animals per device). The bladder tissue was exposed to direct lithotripter probe contact at maximum power for 10 s to produce visible tissue lesions. Acute tissue trauma was evaluated using a simplified scoring model describing the expected bladder wall injuries for histological examination. After 7 days, all animals were killed, necropsied and examined post mortem. For between-group comparisons regarding microscopic histopathologic features, a Chi-square test was used. A p value < 0.05 was considered to be statistically significant. Results Irrespective of the lithotripter used, no systemic signs of toxicity were observed. Histologically, signs of normal ongoing healing were observed on the bladder mucosa. There were no significant differences in histological findings taking changes of the epithelium (p = 0.360), the leucocyte infiltration (p = 0.123), the vascular congestion (p = 0.929) and the edema (p = 1.0) between the groups into account. Conclusions The results of this study demonstrated a comparable safety between all lithotripsy devices.