摘要
目的初步建立自体腹膜移植回肠浆肌层重建膀胱的家兔实验动物模型,为以后动物模型的建立及临床应用这种新的手术方法提供基础实验依据。方法使用封闭饲养的成年大耳白雌兔7只,体质量4.0-5.0kg,在静脉麻醉下行自体腹膜移植回肠浆肌层重建膀胱手术（选取近末段回肠祛除肠黏膜及黏膜下层,取自体腹膜覆盖于带血供的浆肌层表面,再与缺损顶部及前壁部分的膀胱残垣进行吻合修补重建新膀胱）,术后4、8周分别安乐处死动物,取出替代膀胱部位标本进行常规病理学及免疫组织化学检查。结果 7只进行手术实验,其中3只死于术后并发症,剩余4只术后正常存活,无肠梗阻、尿瘘或腹膜炎等并发症发生。所截取回肠段长约4.0cm,腹膜面积约4.0cm×2.5cm,移植腹膜均全部成活,术后观察动物排尿可,黄清。病理学：手术后4周可见移植腹膜全部存活,8周可见移行上皮完全取代腹膜覆盖重建部位,未见肠上皮细胞残留与再生。结论自体腹膜移植回肠浆肌层重建膀胱手术是可行的,它是一种较为理想的肠膀胱手术新方法,同时也为更加接近人体的大型动物模型的建立及为这种新的手术方法可能在临床的应用提供最基本的实验依据。
Objective To develop an ideal substitution material for bladder defect,which can reduce serious complications of urinary intestinal diversion,we establish experimental rabbit model of reconstruction the new bladder by ileal seromuscular with transplantation of autologous peritoneum.This animal research provides the basical ground for the experimental model and further clinical application of replacement bladder.Methods Randomly,seven experimental female rabbits were chosen,and their body weight was 4.0-5.0kg.By intravenous anesthesia,the bladder substitute operation was carried out（to transplant the peritoneum to an ileum segment which mucosa had been removed.These flaps were used to mend and reconstruct the bladder by composite cystoplasty）.Animals were euthanized at 4,8weeks for routine pathology and immunohistochemistry.Results Seven rabbits underwent reconstruction,but three were lost to complications.The length of ileum was 4.0cm,and the area of substitute peritoneum was 4.0cm×2.5cm.Voiding behaviour was normal,and urine was clear in the remainder.At autopsy,reconstructed bladders were healthy.Pathological examination showed that the technique was successful in creating seromuscular segments with no epithelial remnants.When applied surgically,the seromuscular flaps with peritoneum survived at 4weeks and the peritoneum was substituted by transitional epithelium at 8weeks.Conclusion In this experimental rabbit model,reconstruction bladder by autologous peritoneum and seromuscular segment is an ideal approach for which can prevent regrowth by ileal epithelial cells and overcome the complications of conventional enterocystoplasty.Voiding behaviour is normal in the remainder.This animal study provides the basical ground for the large experimental model and further clinical application of the new enterocysplasty.
出处
《重庆医学》
CAS
北大核心
2015年第32期4471-4473,4477,共4页
Chongqing medicine
基金
周大福医学研究专项基金(202836019-04)
关键词
模型
动物
腹膜
膀胱
回肠浆肌
model
animal
peritoneum
bladder
ileal seromuscular
