小鼠肾移植尿路重建术式总结与应用体会

Technical summary and experiences of urinary reconstruction in mouse kidney transplantation

本文总结小鼠肾移植尿路重建方法和技术要点。膀胱瓣和输尿管植入术均是小鼠肾移植中重建尿路的可行术式。膀胱瓣术式主要并发症为术后膀胱瓣及输尿管远端缺血坏死。其发生率受供体小鼠品系和手术技术影响。输尿管植入术式主要并发症为术后尿漏。其发生率受受体小鼠性别和手术技术影响。膀胱瓣术式重点是术中判断膀胱瓣血供并合理修剪缝合膀胱瓣。输尿管植入术式重点是妥善修剪和固定输尿管。输尿管植入术式比膀胱瓣术式快捷。其早期发生的尿路并发症更容易通过二次手术成功修复,但远期尿潴留发生风险高于膀胱瓣术式。手术干预的及时性是成功修复早期尿路并发症的关键因素。

The present paper summarizes the methods and technical key points for urinary reconstruction in mouse kidney transplantation.Both bladder patch and ureter implantation techniques are feasible options for urinary reconstruction in mouse kidney transplantation.The dominant complication in bladder patch technique is ischemic necrosis of patch and distal ureter and is associated with donor mouse strains and surgical skills.The most common complication in ureter implantation technique is urine leakage and is related to recipient mouse gender and technical skills.The key technical points for bladder patch method are estimation of blood supply for bladder patch and properly trimming and suturing bladder walls.The key points for ureter implantation method are properly trimming and fixation of the ureter.Comparing with the bladder patch,the ureter implantation technique is faster,its complications are easier to be repaired by secondary surgery,but the risk of urine retention is higher at late time.The timeliness of surgical intervention is a key factor for successfully repairing the early urinary complications.