游离输尿管移植段应用于输尿管重建的比格犬动物实验研究

Free ureteral transplanting graft for ureteral repair in an experimental animal study

目的:探究自体游离输尿管移植段应用于输尿管重建在比格犬动物实验模型中的安全性及可行性。方法:6只比格犬术前随机分成两组,两组分别随访至术后12周及28周行剖腹观察及留取标本,12周组额外接受静脉肾盂造影观察肾积水及输尿管通畅情况,标本石蜡包埋后行苏木精-伊红染色并观察吻合段输尿管组织学改变。结果:5只比格犬存活至观察终点且未出现明显的术后并发症,IVU提示术侧无或仅存轻度肾积水且未出现输尿管狭窄。组织学检查提示吻合口管腔开放,血管网重建存在。结论:自体游离输尿管移植段应用于输尿管重建在解剖和技术上是可行的,但仍需大样本量和长期随访支持。

Objective：To investigate the feasibility of auto-transplanting free ureteral segments for ureteral repair in an experimental animal model.Method：Six beagles were randomly divided into two groups,and housed for12 and 28 weeks respectively.In the 12-week group,beagles received IVU before sacrifice to evaluate the possible leakage or stricture.Right-sided kidney,ureter and part of the bladder were dissected and stained with HE to observe the histological changes in all groups.Result：Five experimental animals survived healthily till IVU and euthanasia.The IVU indicated patent urine excretion and normal caliber of the neo-ureters.In accordance with the surgical exploration,hydronephrosis was absent or mild compared with the left-sided upper urinary tracts.The histopathological examinations suggested that the neo-ureters had open lumen with complete pseudostratified urothelial lining.The nutrient vessels were observed in both neo-ureteral walls and periureteral adventitial tissue.Conclusion：Auto-transplantation of free ureteral segments is feasible for ureteral repair in our experimental animal study.The procedure can be introduced as a novel option for upper and mid-ureteral reconstruction.