再造阴茎感觉功能重建动物模型的建立

Establishing an experimental animal model of phallic reconstruction with sensory restoration

目的:建立再造阴茎感觉功能重建的动物模型,为临床上改善阴茎再造术后感觉功能探索新术式。方法:以成年新西兰雄兔为实验对象,采用腹壁浅血管筋膜蒂岛状皮瓣行阴茎再造术,切取一段隐神经游离移植,与阴茎背神经端端吻合植入皮瓣后阴茎成形。术后不同时间对再造阴茎进行组织形态学观察和感觉神经肽(calcitonin gene related peptide,CGRP)免疫组化标记。结果:再造阴茎术后1个月时少量CGRP阳性神经纤维仅见于真皮深层,术后3 个月数量明显增多,并开始出现在真皮浅层以及真皮乳头内,术后6个月真皮与表皮交界层以及皮肤附属器周围也可见CGRP阳性纤维。结论:隐神经游离移植与阴茎背神经吻接植入再造阴茎皮瓣内可以获得良好的神经再生,这一动物模型可为临床应用该术式重建再造阴茎感觉功能提供实验依据。

Objective:To establish an experimental phalloplasty model with sensory restoration in rabbits and to explore a new surgical technique to improve the postoperative sensory function in phallic reconstruction. Methods: Adult male New Zealand white rabbit was used. Penile reconstruction was performed with superficial epigastric faciovascular pedicle flap. Free saphenous nerve graft was dissected, embedded in the flap, and end-to-end anastomosed to dorsal nerve of penis. Postoperatively, H-E staining and CGRP immunohistochemical staining were applied to observe the morphology of the regenerated nerves in the reconstructed penis at different stages. Results:Only a few CGRP-positive fibers scattered in deep corium in the reconstructed penis 1 month after surgery, while the quantity of CGRP nerve fibers increased markedly and the CGRP-positive fibers appeared in both superficial corium and papillae corii after 3 months. Six months postoperatively, the positive nerve fibers were also observed around the cutaneous accessories and in the epidermis-corium boundary layer. Conclusion: This rabbit model demonstrates the possibility of a new method for phalloplasty with sensory recovery, which may redound to clinical application.