| Project/Area Number |
17K11523
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Research Field |
Pediatric surgery
|
|---|
| Research Institution | St. Marianna University School of Medicine |
|---|
Principal Investigator |
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
關 保二 聖マリアンナ医科大学, 医学部, 教授 (20309462)
|
|---|
| Project Period (FY) |
2017-04-01 – 2020-03-31
|
| Project Status |
Completed (Fiscal Year 2019)
|
| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
|
|---|
| Keywords | 胎児手術 / 尿路閉塞 / 後部尿道弁 / 胎児胸水 / 膀胱羊水腔シャント / 胸腔羊水腔シャント / 膀胱機能 / 胎児水腫 / 胎児治療 / 胎児期尿路閉塞 / 多嚢胞性異形性腎 / 排尿障害 / 多嚢胞性異形成腎 / 胎児手術学 / 多嚢腎 |
|---|
| Outline of Final Research Achievements |
We developed a percutaneously-inserted valved shunt for obstructive uropathy (OU). Methods: In fetal lambs, creating bladder outlet obstruction at 60 days gestation, shunting the bladder at 80 days, delivering them at term (140-145 days). Initially, the step between the trocar and the insertion sheath was too large. We reduced it. The 2nd modification strengthened the tip of the shunt, changing the bladder end to a triple-fin Malecot. The 3rd modification was creating a barbed pantograph on the fins of the Malecot catheter and improving the retention fins on the amniotic end.
Results: In the 1st group of 10 lambs with OU, only 1 was in place at term. In the 2nd group of 3 lambs, only 1 catheter was successfully placed. In the 3rd group of 10 lambs, we attempted shunt placement in 8 lambs, with 5 successfully placed in the bladder. All were in place at term. Conclusion: Addition of a barbed pantograph on the fins of the bladder end of the shunt improves its retention.
|
| Academic Significance and Societal Importance of the Research Achievements |
胎児期に診断された閉塞性尿路疾患に対して行われる胎児期の膀胱羊水腔シャント術はそのタイミングを逸すると腎機能や膀胱機能の廃絶で胎児死亡につながる。また、膀胱に一定の圧がかかるバルブ付きシャントチューブの挿入で膀胱機能が温存出来る事を報告した。今回、子宮壁から穿刺可能な圧調整バルブ付き膀胱羊水腔シャントチューブを開発し、羊を用いて胎児実験をおこなった。
初期は樹脂製ポートであったが金属製穿刺針に変更した。また穿刺針とポートの隙間を無くした。圧調整部分はスリット状に作成し、先端の形態は留置固定率が高かった三叉マレコット型は留置率が高かった。穿刺可能な圧調整穿刺キットのプロトタイプが完成した。
|
