Yorkshire幼猪腹腔镜回肠转位手术模型的建立方法与体会

The method and experience about the surgery of laparoscopic ileal transposition in yorkshire swine

目的评价腹腔镜回肠转位手术对Yorkshire幼猪血糖代谢的调节作用并讨论模型建立的方法与体会。方法 10只Yorkshire幼猪均实施腹腔镜回肠转位手术,在术前及术后2周行经十二指肠葡萄糖耐量试验,检测连续时间点动物血糖水平绘制成曲线,实验数据采用t检验,并观察手术时间、手术中转率、术后死亡率、伤口感染率、肠瘘发生率以及切口疝发生率等。结果所有幼猪均顺利完成腹腔镜回肠转位术,平均手术时间(107.4±21.5)min,无1例中转开腹,无1例死亡,无伤口感染、肠瘘及切口疝的发生,且术后第2周平均血糖峰值(12.15±2.61)mmol/L较术前(16.05±2.46)mmol/L(t=2.31,P<0.05)和Sham组(13.33±3.67)mmol/L(t=3.0774,P<0.01)显著降低,术后平均峰值时间(113.75±30.21)min较术前(65.00±32.07)min明显延迟(t=3.1297,P<0.01)。结论在Yorkshire猪大型哺乳类动物模型中,腹腔镜下回肠转位手术能有效调节血糖代谢,无明显严重并发症发生,是一种安全可行的代谢外科手术方式。

[ Objective ] To evaluate the effect of laparoscopic ileal transposition operation on glycemia regulation in Yorkshire swine models, and to explore the method and experience of the surgery. [Methods] The Duodenum Glucose Tolerance Tests were performed in 10 Yorkshire swine all accepted laparoscopic ileal transposition. Within pre-operation and two weeks of pre-operation, consecutive blood samples were collected for glucose measurement and comparison. Besides, operation duration, mortality, incidence of conversion to laparotomy, wound infection, intestinal fistula and incisional hernia were observed. [ Results ] Laparoscopic ileal transposition was completed successfully on all swine; There was none of wound infection, intestinal fistula and ineisional hernia. In two weeks postoperation, the peak value of glycemia （12.15±＋2.61） mmol/L was significant lower than that in pre-operation （16.05± 2.46） mmol/L （t =3.0774, P〈0.01）, and the glycemic peak-time was significantly delayed in two weeks post-operation （113.75±30.21） min when compared with pre-operation （65.00±32.07） min （t =3.1297, P 〈0.01）. [ Conclusion] Due to improvement of the glycemia metabolism and without complications, laparoscopic ileal transposition is a safe and feasible metabolic surgery in large mammals.