Portal vein arterialization promotes liver regeneration after extended partial hepatectomy in a rat model

In the current study, we sought to establish a novel rat model of portal vein artefialization （PVA） and evaluate its impact on liver regeneration after extended partial hepatectomy （PH）. A total of 105 Sprague-Dawley rats were randomly assigned to three groups： 68% hepatectomy （the PH group）, portal arterialization after 68% hepatectomy （the PVA group）, and fight nephrectomy only （the control group）. Liver regeneration rate （LRR）, 5-bromo-2-deoxyuridine （BrdU） labeling index, and liver functions were assessed on postoperative day 2, 7, 14 and 28. The 28-day survival rates were compared among the three groups. The 28-day survival rates were similar in all groups （P = 0.331）, and the anastomotic patency was 100%. The LRR in the PVA group was significantly higher than that of the PH group within postoperative 14 days （P 〈 0.05）. The PVA and PH group had increased serum alanine aminotransferase levels （232 ±61 U/L and 212 ±53 U/L, respectively） compared with the control group （101 ±13 U/L） on postoperative day 2, whereas from postoperative day 7 to day 28 there were no differences among the three groups. Serum albumin values were higher after the PVA procedure within postoperative day 14, which gradually became comparable on postoperative day 28 among the three groups. The peaks of BrdU labeling index appeared on postoperative day 2 in all rats, and the PVA procedure was associated with increased BrdU labeling index from postoperative day 7 to 28. The 28-day survival of the PVA rats was comparable. Our findings demonstrate that the PVA procedure utilizing portal vein trunk-renal artery microvascular reconstruction promotes remnant liver regeneration and confers beneficial effects on maintaining and even optimizing liver function after extended partial hepatectomy in rats.

自制单孔通道在成人腹股沟疝腹腔镜手术中的应用评价

目的利用无菌手套及切口保护器自制单孔腹腔镜通道,进行成人腹股沟疝腹腔镜手术,并与常规三孔通道在应用价值、安全性及并发症等方面进行比较评估。方法纳入2017年7月至2019年3月中山大学附属第五医院胃肠外科行单侧或双侧完全腹膜外腹股沟疝修补术(TEP)的160例腹股沟疝患者,分为自制单孔组(SIL-TEP)及三孔组(MP-TEP),各80例,比较2组手术时间、并发症和疼痛视觉模拟量表评分(VAS)等。结果平均手术时间单孔组(86.06±33.69)min、三孔组(89.36±36.30)min,2组差异无统计学意义(P>0.05)。术后2 h VAS评分单孔组(1.89±0.84)分明显低于三孔组(2.36±1.25)分,差异有统计学意义(P=0.005);但术后24 h VAS评分[(1.55±0.50)分vs(1.63±0.48)分],差异无统计学意义(P>0.05)。术后并发症发生率单孔组23.8%、三孔组26.3%,差异无统计学意义(P>0.05)。随访6个月,单孔组无复发病例,三孔组2例疝复发。结论单孔腹腔镜TEP较三孔腹腔镜TEP的切口数量减少,术后即刻疼痛感减轻,未发生严重并发症,手术时间未明显延长。