大鼠原位肾移植管道吻合改良新技术

New improved technologies of pipeline anastomosis of orthotopic kidney transplantation in rats

目的建立一种改良的大鼠原位肾移植模型,评价其可靠性和稳定性。方法采用同体移植,以Sprague Dawley(SD)大鼠作为供、受体,手术技术采用原位移植法,血管及输尿管各采用新式吻合法,即供体左肾动、静脉与受体左肾(切除后)动、静脉均行端端连续外翻式吻合,末端不打结。输尿管采用新式端端吻合法,间断缝针。共施行移植手术常规技术组及改良新技术组各20对,记录各期手术时间,术后连续观测体重及肾功能,第28天处死老鼠检查移植肾及吻合口情况。结果与常规血管吻合技术相比,采用改良新技术的供体手术时间差异无统计学意义,而受体总手术时间明显减少(P<0.05);移植术后肾功能两者差异无统计学意义;吻合后常规技术组出现2例血管狭窄、1例吻合口出血,而改良新技术组无并发症;术后28 d改良新技术组动、静脉吻合口通畅无狭窄,输尿管吻合口无狭窄和瘘,而常规技术组1例动脉吻合口堵塞、2例输尿管狭窄。结论采用血管端端连续外翻式无结吻合、输尿管新式端端间断吻合改良新技术,有效避免了吻合口狭窄与瘘,提高了成功率,是一个很好的移植模型。

Objective To explore a new operation method for constructing a scalable and reliable orthotopic kid- ney transplantation in rats. Methods Sprague Dawley rats were used for the orthotopic isogenic transplantation. A new improved technique for anastomosis of vessels and ureter was established. The vessel＇ s continuous anasto- mosis was performed in an end - to - end manner between the donor＇ s and recipient＇ s left renal vessels after the left donor kidney was removed. Importantly, the last stitch was not tied to the end of the tie. A new end - to - end anastomosis with interrupted stitches by ureter was performed. Twenty transplantation cases were divided into regular technique group and new improved technique group. Operation time and renal function were observed. Rats were sacrificed at 28th Day. The grafts and the stomas were checked. Results Compared with regular tech- nique group, donor operation time had no significant difference, but total recipient operation time was significant- ly reduced in the new improved technique group （ P 〈 0.05 ）. Renal function had no significant difference be- tween these two groups. In the regular technique group, there were two vessel stenosis and one anastomotic blot-ding after transplantation. But there were no complications in the new improved technique group. Twenty - eight days after transplantation, the arterial and venous anastomosis had good patency and no stenosis in the new im- proved technique group. There was no ureteral stenosis and anastomotic leak in the new improved technique group. But there were one artery blockage and two ureteral stenosis. Conclusion In this study, with the new im- proved vascular anastomosis and ureter anastomosis, anastomotic stenosis and leak of vessels and ureter are avoi- ded. The success rate of transplantation is improved. It is a good model for the kidney transplantation in rats.