Tissue-engineered substitution urethroplasty based on decellularized vascular matrix and autologous cells of the buccal mucosa: the first experience


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Urethral strictures and anomalies remain a challenging urological problem. Reconstructive plastic surgery has been shown to be the most effective way to treat them. There are two main types of urethroplasty: anastomosis (anastomotic urethroplasty) and expansion of the urethral lumen using of flaps and grafts (substitution urethroplasty). Currently the ideal material for substitution urethroplasty does not exist. Tissue engineering of the urethra seems to be one of the most promising approaches to address this problem. Various tissues-engineering techniques were proposed for substitution urethroplasty. In this study, tissue-engineering design was based on the decellularized cadaveric arterial wall. The study results demonstrated the feasibility of creating stable tissue-engineered structures with autologous cultured epithelial cells of the buccal mucosa and decellularized matrix from human cadaveric arterial wall (DMCAW). There was a complete engraftment of tissue-engineering design based on DMCAW and buccal mucosa cells, used for substitution urethroplasty in a patient with the bulbar urethral stricture. Postoperatively (within 4 months after surgery) no complications and/or adverse events were observed. However, in the late postoperative period (12 months) there was recurrence of urethral stricture in the middle of the tissue-engineering design and the native urethra that warranted another surgery. Tissue-engineering design based on DMCAW and autologous buccal mucosa is safe as a material for substitution urethroplasty. Further research is required to ascertain the effectiveness of the method.

全文:

受限制的访问

作者简介

P. Glybochko

Sechenov First Moscow State Medical University

Ju. Aljaev

Research Institute of Uronephrology and Human Reproductive Health

V. Nikolenko

Sechenov First Moscow State Medical University

A. Shehter

Research Institute of Molecular Medicine

A. Vinarov

Research Institute of Uronephrology and Human Reproductive Health

L. Istranov

Research Institute of Molecular Medicine

E. Istranova

Research Institute of Molecular Medicine

R. Abojanc

Research Institute of Molecular Medicine

A. Ljundup

Research Institute of Molecular Medicine

M. Danilevskij

Research Institute of Uronephrology and Human Reproductive Health

A. Guller

Research Institute of Molecular Medicine

P. Elistratov

Research Institute of Molecular Medicine

D. Butnaru

Research Institute of Uronephrology and Human Reproductive Health

D. Kantimerov

Sechenov First Moscow State Medical University

Email: kantimeroff@gmaiI.com

G. Mashin

Sechenov First Moscow State Medical University

A. Titov

Sechenov First Moscow State Medical University

A. Proskura

Sechenov First Moscow State Medical University

K. Kudrichevskaja

Sechenov First Moscow State Medical University

参考

  1. Chapple C. Anterior urethral surgery: current concepts and future directions. Eur Urol. 2010;58(1):42-45.
  2. Chapple C., Andrich D., Atala A., Barbagli G., Cavalcanti A., Kulkarni S., Mangera A., Nakajima Y. et al. SIU/ICUD Consultation on Urethral Strictures: The management of anterior urethral stricture disease using substitution urethroplasty. Urology. 2014;83(3 Suppl.):S31-47.
  3. Morey A.F., Watkin N., Shenfeld O., Eltahawy E., Giudice C. SIU/ ICUD Consultation on Urethral Strictures: Anterior urethra - primary anastomosis. Urology. 2014;83(3 Suppl):S23-26.
  4. Santucci R.A., Joyce G.F., Wise M. Male urethral stricture disease. J Urol. 2007;177(5):1667-1674.
  5. Boccon Gibod L., Le Portz B. Endoscopic urethrotomy: does it live up to its promises? J Urol. 1982;127(3):433-435.
  6. Wong S.S., Aboumarzouk O.M., Narahari R., O'Riordan A., Pickard R. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men. Cochrane Database Syst Rev. 2012;12:CD006934.
  7. Santucci R.A., Mario L.A., McAninch J.W. Anastomotic urethroplasty for bulbar urethral stricture: analysis of 168 patients. J Urol. 2002;167(4):1715-19.
  8. Barbagli G., Palminteri E., Guazzoni G., Montorsi F., Turini D., Lazzeri M. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique? J Urol. 2005;174(3):955-57; discussion 957-958.
  9. Alsikafi N.F., McAninch J.W. Long-term outcomes of penile skin graft versus buccal mucosal graft for substitution urethroplasty of the anterior urethra. J Urol. 2005;173(87).
  10. Barbagli G., Palminteri E., Bartoletti R., Selli C., Rizzo M. Long-term results of anterior and posterior urethroplasty with actuarial evaluation of the success rates. J Urol. 1997;158(4):1380-1382.
  11. Andrich D.E. The long-term results of urethroplasty. J Urol. 2003;170(1):90-92.
  12. Dubey D., Vijjan V., Kapoor R., Srivastava A., Mandhani A., Kumar A., Ansari M.S. Dorsal onlay buccal mucosa versus penile skin flap urethroplasty for anterior urethral strictures: results from a randomized prospective trial. J Urol. 2007;178(6):2466-2469.
  13. Godwin R.J. Urethral stone formation following urethroplasty. Br J Radiol. 1977;50(590):113-115.
  14. Mangera A., Chapple C.R. Tissue engineering in urethral reconstruction - an update. Asian J Androl. 2013;15(1):89-92.
  15. Bhargava S., Chapple C.R. Buccal mucosal urethroplasty: is it the new gold standard? BJU Int. 2004;93(9):1191-1193.
  16. Barbagli G., Vallasciani S., Romano G., Fabbri F., Guazzoni G., Lazzeri M. Morbidity of oral mucosa graft harvesting from a single cheek. Eur Urol. 2010;58(1):33-41.
  17. Mangera A., Patterson J.M., Chapple C.R. A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures. Eur Urol. 2011;59(5):797-814.
  18. el-Kassaby A., AbouShwareb T., Atala A. Randomized comparative study between buccal mucosal and acellular bladder matrix grafts in complex anterior urethral strictures. J Urol. 2008;179(4):1432-1436.
  19. Fiala R., Vidlar A., Vrtal R., Belej K., Student V. Porcine small intestinal submucosa graft for repair of anterior urethral strictures. Eur Urol. 2007;51(6):1702-08; discussion 1708.
  20. Глыбочко П.В., Аляев Ю.Г., Николенко В.Н., Шехтер А.Б., Винаров А.З., Истранов Л.П., Истранова Е.В., Абоянц Р.К., Люндуп А.В., Данилевский М.И., Гуллер А.Е., Елистратов П.А., Бутнару Д.В., Кантимеров Д.Ф., Машин Г.А., Титов А.С., Проскура А.В., Кудричевская К.В. Экспериментальное обоснование создания матрицы на основе децеллюляризированной сосудистой стенки с целью последующей заместительной уретропластики. Урология. 2014;6:41-46.
  21. Engel O., Reiß P., Schwaiger B., Pfalzgraf D., Dahlem R., Fisch M. Tissue-engineered buccal mucosa urethroplasty. Outcome of our first 10 patients. J Urol. 2012;187(4):e6.
  22. Fossum M., Skikuniene J., Orrego A., Nordenskjöld A. Prepubertal follow-up after hypospadias repair with autologous in vitro cultured urothelial cells. Acta Paediatr. 2012;101(7):755-760.
  23. Bhargava S., Patterson J.M., Inman R.D., MacNeil S., Chapple C.R. Tissue-engineered buccal mucosa urethroplasty-clinical outcomes. Eur. Urol. 2008;53(6):1263-1269.
  24. Raya-Rivera A., Esquiliano D.R., Yoo J.J., Lopez-Bayghen E., Soker S., Atala A. Tissue-engineered autologous urethras for patients who need reconstruction: an observational study. Lancet. 2011;377(9772):1175-1182.
  25. Роговая О.С., Васильев A.B., Файзулин А.К., Демин Н.В. Применение клеточных технологий для реконструкции уретры в детской урологии. Андрология и генитальная хирургия. 2009;4:36-39.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Bionika Media, 2015
##common.cookie##