摘要
目的探讨腹腔镜下活体猪建立改良胰肾联合移植模型的可行性。方法选用16只活体猪采用随机数表法分为供体和受体各8只,受体猪行双肾切除后,将供体胰腺动脉和静脉分别与右侧肾动脉和静脉吻合,胰液引流至空肠。肾动、静脉分别与髂内动静脉吻合。输尿管(或肾盂)与左侧原输尿管(或肾盂)吻合。观察术中并发症及即刻血供复通情况。采用平均值和标准差来描述手术总体及各步骤手术时间和出血量。结果8只受体猪中有5只完成整个手术过程,平均手术时间为(405±9)min,手术平均出血量为(122±64)ml。所有受体均完成血管吻合术,2例肠吻合失败,另1例输尿管失败。术后成活模型猪中3只在2 h内死亡(循环衰竭),2只在24 h内死亡(呼吸循环衰竭),术后尸检证实腔镜下血管吻合可靠,未见明显狭窄。结论猪动物实验模型中进行腹腔镜改良胰肾联合移植手术上在解剖结构及技术理论上可行。
Objective To explore the feasibility of establishing an modified laparoscopic pancreas-kidney co-transplantation model in living pigs.Methods Totally,16 living pigs were randomly assigned as donors and recipients using a random number table method.In the recipients,bilateral nephrectomy was performed,followed by anastomosis of the donor pancreatic artery and vein to the right renal artery and vein,respectively,with pancreatic juice drainage into the jejunum.The renal artery and vein were anastomosed to the internal iliac artery and vein,respectively.The ureter(or renal pelvis)was anastomosed to the left native ureter(or renal pelvis).Intraoperative complications and immediate reperfusion were observed.The overall and step-by-step surgery duration and blood loss were described using mean and standard deviation.Results In total,5 out of 8 recipient pigs completed the entire surgical procedure.All recipients underwent successful vascular anastomosis,average surgery duration of(405±9)min and an average blood loss of(122±64)ml.There were two animals experiencing intestinal anastomosis failure,and one experiencing ureteral failure.Among the surviving model pigs postoperatively,three died within 2 h(due to circulatory failure)and two died within 24 h(due to respiratory and circulatory failure).Postmortem examinations confirmed the reliability of laparoscopic vascular anastomosis without significant stenosis.Conclusion Performing modified laparoscopic pancreas-kidney combined transplantation in the porcine animal model is feasible in terms of anatomical structure and technical theory.
作者
陈元浩
李高
李彦生
赵昱
张鑫
Chen Yuanhao;Li Gao;Li Yansheng;Zhao Yu;Zhang Xin(Department of Urology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100043,China)
出处
《中华实验外科杂志》
CAS
2024年第6期1245-1248,共4页
Chinese Journal of Experimental Surgery
关键词
胰肾联合移植
模型
动物
腹腔镜
Pancreas-kidney combined transplantation
Model,animal
Laparoscopic surgery