Beagle犬腹腔镜活体供肾-移植模型的建立

Establishment of laparoscopic live donor nephrectomy-transplantation model in beagle canine

目的探讨Beagle犬腹腔镜活体供肾一移植模型建立的安全性和可行性。方法8条beagle犬随机分为两组，实验组行腹腔镜左肾供肾切取术，对照组行开放左肾供肾切取术，两组分别行组内同种异体肾移植术并置于左侧髂窝，同时切除自体右肾。统计两组取肾手术时间、术中失血量、热缺血时间、切口长度，肾移植手术时间、术中失血量、供肾动静脉吻合时间等手术指标及术后实验犬肌酐、尿素氮变化情况。结果实验组腹腔镜供肾切取术均成功完成，无一例中转开腹，其中供肾切取手术时间（61．5±11．0）min，术中失血量（13．9±6．8）ml，供肾热缺血时间（81．4±9．3）S；对照组开放供肾切取术，无一例失败，其中供肾切取手术时间（66．1±13．5）min，术中失血量（32．7±4．8）ml，供肾热缺血时间（28．5±5．6）s；8例次同种异体肾移植术，全部成功，受体移植手术时间（87，3±13．9）min，术中失血量（13．5±5．2）ml，动脉吻合时间（19．8±6．7）min，静脉吻合时间（22．8±3．5）min，术后1个月观察期间内，无漏尿、出血、感染等并发症发生，术后第3天实验犬肌酐、尿素氮指标恢复正常。结论Beagle犬腹腔镜活体供肾．移植模型的建立操作相对简便、容易掌握，成活率高，安全、可靠。

Objective To detect the safety and feasibility of the laparoscopic live donor nephrecto- my-transplantation model in beagle canine. Methods 8 beagle dogs were randomly divided into two groups ： the experimental group of laparoscopic nephrectomy for the left kidney, and the control group with open nephrectomy. In the 2 groups, all kidneys were placed in the left side of the iliac fossa, and all the right kidneys were removed at the same time. The operation time, blood loss,warm ischemia time,length of incision, the time of renal arteriovenous anastomosis,the blood creatinine and urea nitrogen levels after op- eration were monitored. Results The laparoscopic donor nephrectomy were performed successfully in the experimental group with the average nephrectomy time （61.5 ± 11. 0） min,blood loss （13.9 ± 6. 8） ml,renal warm ischemia time （81.4 ± 9. 3 ） s; The open nephrectomy were performed successfully in the control group with the average nephrectomy operative time （66. 1 ± 13.5） min,blood loss （32. 7 ±4. 8） ml,renal warm ischemia time （ 28.5 ± 5.6 ） s ; All the surgeries of kidney transplantation were successful with average operation time （87. 3 ± 13.9） min, blood loss （13.5 ± 5.2 ） ml, arterial anastomosis time （19. 8 ± 6. 7 ） min, venous anastomosis time （ 22. 8 ± 3.5 ） min. After 1 month of observation period, no leakage of urine,bleeding, infection or other complications were occurred. Three days after surgery, the creatinine and urea nitrogen recovered to normal. Conclusion Beagle canine laparoscopic live donor kidney-transplantation model is simple and practicable with high survival rate.