Name: microscopic electric rotary grinding of plaques combined with graft repair in the management of peyronie's disease
Uploaded: 2024-03-15T14:10:00
Description: Read this Scientific Article Protocol about Microscopic Electric Rotary Grinding of Plaques Combined with Graft Repair in the Management of Peyronie's Disease at JoVE.com

该协议是按照《赫尔辛基宣言》的原则执行的，此处描述的所有方法均已获得大平医院伦理委员会（IRB：2023168）的批准。已获得患者的书面同意。
1. 操作仪器
<ol><li>在手术显微镜下进行所有程序。确保 材料表中提到的灭菌器械和其他设备的可用性。在手术过程中将放大倍率设置在 3x-6x 之间，这对于解剖来说已经足够了。</li>
</ol><s...

<ol>
	<li>Tsambarlis, P., Levine, L. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nonsurgical+management+of+Peyronie's+disease.">Nonsurgical management of Peyronie's disease.</a> Nat Rev Urol. 16 (3), 172-186 (2019).</li><li>Sharma, K. L., Alom, M., Trost, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+etiology+of+Peyronie's+disease:+Pathogenesis+and+genetic+contributions.">The etiology of Peyronie's disease: Pathogenesis and genetic contributions.</a> Sex Med Rev. 8 (2), 314-323 (2020).</li><li>Almeida, J. L., Fel&#237;cio, J., Martins, F. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+planning+and+strategies+for+Peyronie's+disease.">Surgical planning and strategies for Peyronie's disease.</a> Sex Med Rev. 9 (3), 478-487 (2021).</li><li>Chung, P. H., Han, T. M., Rudnik, B., Das, A. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peyronie's+disease:+What+do+we+know+and+how+do+we+treat+it.">Peyronie's disease: What do we know and how do we treat it.</a> Can J Urol. 27 (3), 11-19 (2020).</li><li>Green, B., Flores, A., Warner, J., Kohler, T., Helo, S., Trost, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+collagenase+clostridium+histolyticum+to+surgery+for+the+management+of+Peyronie's+disease:+A+randomized+trial.">Comparison of collagenase clostridium histolyticum to surgery for the management of Peyronie's disease: A randomized trial.</a> J Urol. 210 (5), 791-802 (2023).</li><li>Ziegelmann, M. J., Bajic, P., Levine, L. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peyronie's+disease:+Contemporary+evaluation+and+management.">Peyronie's disease: Contemporary evaluation and management.</a> Int J Urol. 27 (6), 504-516 (2020).</li><li>Mois&#233;s Da Silva, G. V., D&#225;vila, F. J., Rosito, T. E., Martins, F. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global+perspective+on+the+management+of+peyronie's+disease.">Global perspective on the management of peyronie's disease.</a> Front Reprod Health. 4, 863844 (2022).</li><li>Rice, P. G., Somani, B. K., Rees, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Twenty+years+of+plaque+incision+and+grafting+for+Peyronie's+disease:+A+review+of+literature.">Twenty years of plaque incision and grafting for Peyronie's disease: A review of literature.</a> Sex Med. 7 (2), 115-128 (2019).</li><li>Hauck, E. W., Weidner, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fran&#231;ois+de+la+Peyronie+and+the+disease+named+after+him.">Fran&#231;ois de la Peyronie and the disease named after him.</a> Lancet. 357 (9273), 2049-2051 (2001).</li><li>Manka, M. G., White, L. A., Yafi, F. A., Mulhall, J. P., Levine, L. A., Ziegelmann, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparing+and+contrasting+Peyronie's+disease+guidelines:+Points+of+consensus+and+deviation.">Comparing and contrasting Peyronie's disease guidelines: Points of consensus and deviation.</a> J Sex Med. 18 (2), 363-375 (2021).</li><li>Russo, G. I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparative+effectiveness+of+intralesional+therapy+for+Peyronie's+disease+in+controlled+clinical+studies:+A+systematic+review+and+network+meta-analysis.">Comparative effectiveness of intralesional therapy for Peyronie's disease in controlled clinical studies: A systematic review and network meta-analysis.</a> J Sex Med. 16 (2), 289-299 (2019).</li><li>Bole, R., Ziegelmann, M., Avant, R., Montgomery, B., Kohler, T., Trost, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient's+choice+of+health+information+and+treatment+modality+for+Peyronie's+disease:+A+long-term+assessment.">Patient's choice of health information and treatment modality for Peyronie's disease: A long-term assessment.</a> Int J Impot Res. 30 (5), 243-248 (2018).</li><li>Chung, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Penile+reconstructive+surgery+in+Peyronie+disease:+Challenges+in+restoring+normal+penis+size,+shape,+and+function.">Penile reconstructive surgery in Peyronie disease: Challenges in restoring normal penis size, shape, and function.</a> World J Mens Health. 38 (1), 1-8 (2020).</li><li>Terrier, J. E., Tal, R., Nelson, C. J., Mulhall, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Penile+sensory+changes+after+plaque+incision+and+grafting+surgery+for+Peyronie's+disease.">Penile sensory changes after plaque incision and grafting surgery for Peyronie's disease.</a> J Sex Med. 15 (10), 1491-1497 (2018).</li><li>Levine, L. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Partial+plaque+excision+and+grafting+(peg)+for+Peyronie's+disease.">Partial plaque excision and grafting (peg) for Peyronie's disease.</a> J Sex Med. 8 (7), 1842-1845 (2011).</li><li>Sokolakis, I., Pyrgidis, N., Hatzichristodoulou, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+collagen+fleece+(tachosil)+as+grafting+material+in+the+surgical+treatment+of+Peyronie's+disease.+A+comprehensive+narrative+review.">The use of collagen fleece (tachosil) as grafting material in the surgical treatment of Peyronie's disease. A comprehensive narrative review.</a> Int J Impot Res. 34 (3), 260-268 (2022).</li></ol>

在这项研究中，我们开发了一种新的手术策略，将斑块的微观电动旋转研磨与移植物修复相结合，以控制帕金森病。初步结果表明，纠正效果令人满意。据我们所知，这是首次将显微技术与电动研磨钻联合应用于帕金森病手术矫正的研究。 
目前，PD患者被推荐了各种治疗方案，从口服药物和病灶内注射到手术干预，具体取决于畸形的阶段和严重程度9。然而?...

佩罗尼氏病 （PD） 是一种慢性纤维化疾病，会导致畸形、弯曲、疼痛、性残疾，甚至导致心理困扰1。帕金森病可能代表一种异质性疾病，可遗传和环境驱动的表观遗传因素都有助于其发展和进展2. 
帕金森病报告的流行病学各不相同，由于对可用治疗方案的尴尬和误解，可能被低估，在不同种族和队列中为 0.4%-20.3% 2,3。帕金森病的治疗包括保守治疗或手术干预，具体取决于症状的严重程度和稳定性。保守治疗是活动期最常见的建议，而更具侵入性的治疗则保留在被动期4。最近一项随机对照试验评估了胶原酶溶组织梭菌 （CCH） + RestoreX牵引与手术 + RestoreX牵引在佩罗尼氏病管理中的疗效，表明这两种策略之间的结果相当5.
尽管牵引疗法和病灶内注射对许多患者有一定程度的改善，但手术干预仍然是这种疾病的最终解决方案，特别是对于那些有严重弯曲和沙漏或铰链畸形的患者1.目前，矫直术，如折叠术和牙菌斑切口或部分切除术和移植术，是矫正曲率或畸形的最可靠方法6。然而，报告的方法具有很高的感觉丧失率、勃起功能丧失或美容不满意 5,7,8。
电动研磨机通常用于神经外科和骨科，作为骨骼整形的有效工具。它在研磨硬组织（如骨骼）方面表现出很高的效率，同时对软组织造成的损害最小。这一特性使其在治疗硬斑块方面具有独特的优势。
在这项研究中，我们开发了一种新的管理策略，包括纤维斑块的微观电动旋转研磨和使用阴道膜或牛心包作为移植材料治疗帕金森病，这提供了高水平的患者满意度。该协议适用于具有严重弯曲或其他畸形的患者，这些畸形限制了他们进行令人满意的插入式的能力。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Bovine pericardium</td>
			<td>Guanhao Biotech, Guangzhou, Co.</td>
			<td>TB-S6050/TB-S3050</td>
			<td></td>
		</tr>
		<tr>
			<td>Cefuroxime sodium</td>
			<td>Yiyi Saite, Co., Ltd</td>
			<td>N/A</td>
			<td>0.75 g</td>
		</tr>
		<tr>
			<td>Disposable Radiofrequency Ablation Electrode (Multifunctional Surgical Dissector)</td>
			<td>Chongqing Andiyingge Techology Developement Co.,Ltd</td>
			<td>SZ02068</td>
			<td></td>
		</tr>
		<tr>
			<td>Operating microscope system</td>
			<td>Carl Zeiss Co., Ltd</td>
			<td>OPMI VARIO 700</td>
			<td></td>
		</tr>
		<tr>
			<td>Polyglactin thread</td>
			<td>Ethicon, LLC</td>
			<td>Vicryl, W9981</td>
			<td></td>
		</tr>
		<tr>
			<td>Ropivacaine</td>
			<td>Yiyi Saite, Co., Ltd</td>
			<td>N/A</td>
			<td>0.5%,2.5 mL</td>
		</tr>
		<tr>
			<td>Vacuum device</td>
			<td>Shenzhen Chunyu Biotech Co.</td>
			<td>CY078</td>
			<td></td>
		</tr>
	</tbody>
</table>

microscopic electric rotary grinding of plaques combined with graft repair in the management of peyronie's disease

佩罗尼氏病 （PD） 的临床特征是局部纤维斑块的形成，主要在白膜上，尤其是在阴茎背侧区域。这些斑块是这种情况的标志性特征，导致受影响的个体弯曲、畸形和疼痛的勃起。尽管存在各种非手术治疗方案，但其总体效果有限。因此，手术干预已成为患有严重曲率畸形和相关勃起功能障碍患者的最终选择。我们的研究团队成功地采用了一种组合方法，包括显微镜下电动旋转研磨纤维斑块和使用阴道膜或牛心包作为移植材料来修复白膜膜的缺陷，以治疗帕金森病。这种方法在恢复形状方面一直产生非常令人满意的结果，具有出色的美容效果和显着提高的性满意度。 
该方案旨在提出一种全面的手术管理策略，利用牙菌斑的电动旋转研磨并使用阴道被膜修复白膜的缺损，这代表了治疗帕金森病的最佳手术策略。

2021 年 1 月至 2023 年 5 月共纳入 21 名患者。患者年龄从34岁到68岁不等，平均年龄在51.5±9.4岁之间。在患者总数中，8 例 （38.1%） 患有糖尿病。16例患者（76.2%）表现为阴茎明显单纯性背曲，曲率角为60-90°，5例患者（23.8%）表现为复杂沙漏样畸形，既有背屈又有侧曲，或伴有收缩样畸形，弯曲角度范围为45-60°。人口统计信息如 表1所示。
表 2 显示了术?...

Read this Scientific Article Protocol about Microscopic Electric Rotary Grinding of Plaques Combined with Graft Repair in the Management of Peyronie's Disease at JoVE.com

Microscopic Electric Rotary Grinding of Plaques Combined with Graft Repair in the Management of Peyronie's Disease

所提出的方案描述了一种用于治疗佩罗尼氏病的显微镜手术方法，通过使用斑块的电动旋转研磨，然后使用阴道膜或牛心包作为移植物来修复白膜的缺陷。

显微镜下电旋转研磨牙菌斑联合移植物修复治疗佩罗尼氏病

Peyronie's Disease (PD) is clinically characterized by the development of localized fibrous plaques, primarily on the tunica albuginea, especially on the ...

将麻醉患者仰卧位放在手术床上后，使用橡皮筋作为止血带绑住阴茎根部。将生理盐水注射到阴茎海绵体中，以诱导人工勃起。在冠状沟下方做一个圆形切口。对包皮和浅筋膜进行圆周去切，并暴露 Buck 筋膜。使用一个小的圆形刀片，沿着阴茎干的两侧在靠近尿道的 Buck 筋膜水平处做大约 4 到 6 厘米的纵向切口。确保切口完全暴露阴茎背侧的斑块区域，而不会损伤神经和血管。使用显微剪刀或细针电极，解剖 Buck 筋膜，并小心地将其从两侧分离到阴茎背侧的中线区域。在完全暴露白膜背侧的斑块后，标记斑块的范围。使用电动研磨钻，消融纤维化斑块。根据缺损大小，使用单侧或双侧阴道被膜移植物或牛心包来修复白膜的缺损。接下来，重新定位神经血管束和 Buck 筋膜。将生理盐水重新注射到海绵体中，以评估弯曲。如有必要，对白膜进行轻微的折叠以进行完全曲率校正。小心地分别修复和缝合缩回的 dartos 筋膜和包皮。

Research

JoVE Journal

Medicine

Surgical Management of Meatal Stenosis with Meatoplasty

管理与Meatoplasty尿道外口狭窄的外科治疗

Meatal stenosis is a common urologic complication after circumcision.  Children present to their primary care physicians with complaints of deviated ...

科研

医学

High Throughput Sequential ELISA for Validation of Biomarkers of Acute Graft-Versus-Host Disease

高通量顺序酶联免疫吸附试验的急性移植物抗宿主病的生物标志物的验证

Unbiased discovery proteomics strategies have  the potential to identify large numbers of novel biomarkers that can improve  diagnostic and prognostic ...

Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice

载脂蛋白 E 缺乏小鼠盐皮质激素受体的活化诱导动脉粥样硬化斑块的研究

Atherosclerosis is due to a chronic inflammatory response affecting vascular endothelium and is promoted by several factors such as hypertension, ...

Using a Chemical Biopsy for Graft Quality Assessment

使用化学活检进行移植质量评估

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated ...

The Microscopic Transcanal Approach in Stapes Surgery Revisited

重新审视镫骨手术中的显微经管入路

The microscopic transcanal (aka transmeatal) surgical approach was first described in the 60s, offering a minimally invasive means of reaching the ...

Establishment and Evaluation of a Porcine Vein Graft Disease Model

猪静脉移植病模型的建立与评价

Venous graft disease (VGD) is the leading cause of coronary artery bypass graft (CABG) failure. Large animal models of CABG-VGD are needed for the ...

Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis

腹腔镜肝切除术联合术中微波消融术在结直肠癌肝转移中的应用

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to ...

Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst

显微镜囊肿切除术治疗诊断为附睾囊肿的患者

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative ...

Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy

非接触式腹腔镜胰十二指肠切除术中未接触突的管理

Laparoscopic pancreatoduodenectomy (LPD) is a demanding abdominal operation that necessitates meticulous surgical skills and teamwork. The management of ...

Optimization of Processing of Tiebangchui with Highland Barley Wine Based on the Box-Behnken Design Combined with the Entropy Method

基于Box-Behnken设计结合熵法的高原青稞酒铁板廚加工优化

The processing of toxic ethnomedicines is of great significance for their safe clinical application. Thus, the limitations of traditional processing ...