猪原位节段性小肠移植模型的建立和技术优化  

Establishment and modification of a pig model of orthotopic segmental small bowel transplantation

作　　者：郭明晓[1] 路春雷[1] 陈东峰[1] 张海峰[1] 高鹰[1] 李幼生[2] 

机构地区：[1]山东大学附属临沂市人民医院腹腔镜外科,临沂276000 [2]南京大学医学院附属金陵医院(南京军区南京总医院)解放军普通外科研究所,南京210002

出　　处：《医学研究生学报》2016年第3期295-298,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81500688);山东省自然科学基金(ZR2015HL033)

摘　　要：目的理想的小肠移植模型是进行小肠移植相关研究的前提保障,文中拟通过改进血管重建及部分外科手术技术,建立原位节段性小肠移植模型。方法健康清洁型大白猪20只,供受体各10只,术前48 h禁食。供体末端回肠及其系膜游离后灌洗保存,切除受体末端小肠,供受体血管行端-端吻合(游离保留较长的供、受体血管,吻合前确定移植肠摆放位置,垂直摆放血管阻断夹,以使血管吻合姿态调整为吻合左右壁,采用连续缝合的方法,妥善固定移植肠),受体行消化道重建以恢复肠道连续性。结果共进行移植10例,成功9例。供体手术时间100 min,受体手术时间172 min,热缺血时间1.3min,冷却血时间96 min,血管吻合时间27.6 min。无一只猪术后出现吻合口瘘。结论原位节段性小肠移植模型操作简单,是进行小肠移植相关研究的理想模型。Objective An ideal small bowel transplantation model is the prerequisite and guarantee of small bowel transplantation-related researches. The aim of this study is to establish a pig model of orthotopic segmental small bowel transplantation by modification of blood vessel reconstruction and surgical techniques. Methods Twenty healthy pigs were equally assigned as donors and recipients. The superior mesenteric vessels were freed and the distal ileum harvested as grafts. After irrigation and preservation,the small bowel was transplanted by end-to-end anastomosis of the superior mesenteric arteries and veins,and then the small bowel was reconstructed simultaneously to restore intestinal continuity,with the proximal part of the graft brought out as a stoma for the purpose of graft monitoring. Results Transplantation was successfully performed in 9 of the 10 cases,with a success rate of 90%. The donor operations averaged 100 min,recipient operations 172 min,warm ischemia 1. 3 min,cold ischemia 96 min,and vascular anastomosis27. 6 min. No postoperative anastomosis fistula occurred in any of the cases. Conclusion The pig model of orthotopic segmental small bowel transplantation is ideal for small bowel transplantation-related researches.

关 键 词：小肠移植 模型 猪 

分 类 号：R656.7[医药卫生—外科学]