背景:如果管理不当,气管病理学可能会危及生命。对于某些病理,今天仍然存在一些手术限制,比如严重的气管软化症,或需要切除长段气管时。聚(ε-己内酯)(PCL)是一种聚合物,其最近因其在动物模型中的气管手术和某些人类儿科病例中的用途而受到欢迎,希望解决这些困难情况。PCL可以3D打印或通过模具制造,以创建气管支架,夹板,甚至重建完整的圆周气管缺损。
目的:要进行范围审查,并探讨PCL在气管手术中的应用。
方法:在Embase中进行文献检索,MEDLINE,并且进行了BIOSIS,包括2018年12月21日之前提供的所有文章,没有任何语言限制.我们包括了所有研究PCL植入物使用的原始研究,支架夹板,脚手架,或在体内气管手术中移植。在纳入分析之前,由两名独立作者对所有文章进行评估。
结果:本研究共纳入27篇文献。所有文章都是原创研究,主要包括介入研究(92.4%),还有2例病例报告(7.4%)。文章发表在过去十年,出版物范围从2009年到2019年。用于气管手术的最常见的动物模型是新西兰兔(n=19,70%)。两项研究(7%)还描述了在总共4例人类病例中使用PCL。为了研究PCL重建的气道,组织学和支气管镜检查是最常用的分析方法,分别占88.9%和70.4%。还使用包括CT扫描在内的成像方式进行了气道分析(n=9,33.3%),MRI(n=2,7.4%),X射线(n=1,3.7%)。17(62.9%)的研究使用3D打印工艺来创建其PCL植入物。
结论:总体而言,本文综述了PCL在气管重建和气管支架/夹板置入中的可行性。它强调了迄今为止关于这一主题的文献的共同趋势和局限性。
BACKGROUND: Tracheal pathology can be life-threatening if not managed appropriately. There are still some surgical limitations today for certain pathologies, such as in severe
tracheomalacia, or when long segments of trachea need to be resected. Poly(ε-caprolactone) (PCL) is a polymer that has recently gained popularity for its use in tracheal surgeries in animal models and in certain human pediatric cases in hopes of addressing these difficult situations. PCL can be 3D printed or manufactured through molds to create tracheal stents, splints, patches and even to reconstruct full circumferential tracheal defects.
OBJECTIVE: To perform a scoping
review, and explore insights into the applications of PCL for tracheal surgeries in-vivo.
METHODS: A literature search in Embase, MEDLINE, and BIOSIS was performed to include all articles available prior to December 21, 2018 without any language restrictions. We included all original research that investigated the use of a PCL implant, stent, splint, scaffold, or graft in tracheal surgeries in-vivo. Assessment of all articles were performed by two independent authors prior to inclusion for analysis.
RESULTS: A total of 27 articles were included in the study. All articles were original research studies, primarily consisting of interventional studies (92.4%), there was also 2 case reports (7.4%). Articles were published in the last decade, publications range from 2009 to 2019. The most common animal model used for the tracheal surgeries were the New Zealand rabbits (n = 19, 70%). Two studies (7%) also described the use PCL in a total of 4 human cases. To investigate the PCL reconstructed airways, histology and bronchoscopy were the most commonly implemented methods of analysis in 88.9% and 70.4% respectively. Airway analysis was also done using imaging modalities including CT scan (n = 9, 33.3%), MRI (n = 2, 7.4%), X-ray (n = 1, 3.7%). 17 (62.9%) of the studies used 3D printing processes to create their PCL implants.
CONCLUSIONS: Overall, this
review demonstrates the feasibility of PCL in tracheal reconstruction and tracheal stenting/splinting. It highlights common trends and the limitations of the literature thus far on this topic.