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中华肝脏外科手术学电子杂志 ›› 2017, Vol. 06 ›› Issue (05) : 410 -414. doi: 10.3877/cma.j.issn.2095-3232.2017.05.017

所属专题: 文献

基础研究

磁压榨吻合技术在大鼠肝移植模型建立中的应用
杨丽斐1, 陆建文2, 史源3, 马涛4, 董鼎辉4, 吴荣谦1, 吕毅4,()   
  1. 1. 710061 西安交通大学第一附属医院陕西省再生医学与外科工程研究中心
    2. 710061 西安交通大学第一附属医院肝胆外科
    3. 300192 天津市第一中心医院器官移植中心
    4. 710061 西安交通大学第一附属医院陕西省再生医学与外科工程研究中心;710061 西安交通大学第一附属医院肝胆外科
  • 收稿日期:2017-07-10 出版日期:2017-10-10
  • 通信作者: 吕毅
  • 基金资助:
    国家自然科学基金(81470896)

Application of magnetic compression anastomosis in establishment of rat models of liver transplantation

Lifei Yang1, Jianwen Lu2, Yuan Shi3, Tao Ma4, Dinghui Dong4, Rongqian Wu1, Yi Lyu4,()   

  1. 1. Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
    2. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
    3. Organ Transplantation Center, Tianjin First Center Hospital, Tianjin 300192, China
    4. Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
  • Received:2017-07-10 Published:2017-10-10
  • Corresponding author: Yi Lyu
  • About author:
    Corresponding author: Lyu Yi, Email:
引用本文:

杨丽斐, 陆建文, 史源, 马涛, 董鼎辉, 吴荣谦, 吕毅. 磁压榨吻合技术在大鼠肝移植模型建立中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2017, 06(05): 410-414.

Lifei Yang, Jianwen Lu, Yuan Shi, Tao Ma, Dinghui Dong, Rongqian Wu, Yi Lyu. Application of magnetic compression anastomosis in establishment of rat models of liver transplantation[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2017, 06(05): 410-414.

目的

采用磁压榨吻合(MCA)技术代替传统缝合法,建立一种无缝线快速吻合肝移植模型,为临床肝移植相关问题研究搭建一个良好的技术平台。

方法

SPF级健康雄性SD成年大鼠300只,体重为250~280 g,供、受体各150只。以"双袖套"法为基础,采用MCA行大鼠肝上下腔静脉(SHVC)重建建立大鼠原位肝移植模型。练习分3个阶段,分为前期40对,中期40对,后期70对。观察并记录各阶段大鼠肝移植术手术时间及术后1、5 d存活率;分析手术失败的原因并改良手术技巧。

结果

供体手术时间从前期(45.0±5.0)min减少至后期(22.0±3.0)min,无肝期从(28.5±5.0)min减少至(11.8±3.1)min,受体手术时间从(76.1±7.0)min减少至(47.7±2.9)min。前期、中期、后期的术后1、5 d存活率分别为25%(10/40)、80%(32/40)、97%(68/70)和5%(2/40)、45%(18/40)、83%(58/70)。前期大鼠肝移植手术失败主要是由于无肝期长、门静脉(PV)-肝下下腔静脉(IHVC)吻合失败、术中出血多,受体多数未完成手术或术后2~4 h死亡。中、后期大鼠肝移植手术失败主要是由于PV-IHVC吻合失败。

结论

采用改良的MCA可快速吻合SHVC,提高移植成功率,为初学者减少练习难度与周期,建立了一种理想的肝移植模型。

Objective

Magnetic compression anastomosis (MCA) was adopted to substitute traditional suturing method and establish a sutureless and rapid anastomosis liver transplantation (LT) model, aiming to establish a favorable technical platform for studying LT-related problems in clinical practice.

Methods

A total of 300 healthy male SD adult rats (SPF grade), weighed 250-280 g, were evenly divided into the donors (n=150) and recipients (n=150). Based upon the two-cuff technique, the rat models of orthotopic LT were established by the reconstruction of suprahepatic inferior vena cava (SHVC) using MCA. Practice stages were subject to the early- (40 pairs), middle- (40 pairs) and advanced-stage (70 pairs). The operation time and postoperative 1-, 5-d survival rates of the rats during each stage were observed and recorded. The causes of surgical failure were analyzed to improve the surgical skills.

Results

The operation time of the donors was reduced from (45.0±5.0) min in the early stage to (22.0±3.0) min in the advanced stage. The anhepatic phase was reduced from (28.5±5.0) min to (11.8±3.1) min. The operation time of the recipients was reduced from (76.1±7.0) min to (47.7±2.9) min. The postoperative 1-, 5-d survival rate in the early-, middle- and advanced-stage was respectively 25%(10/40), 80%(32/40), 97%(68/70) and 5%(2/40), 45%(18/40), 83%(58/70). In the early-stage, the failure of the LT mainly resulted from long anhepatic phase, failure of portal vein (PV)-infrahepatic inferior vena cava (IHVC) anastomosis and excessive intraoperative hemorrhage. A majority of the recipients failed to complete the surgery or died at postoperative 2-4 h. During the middle- and advanced-stage, the failure of LT resulted from failed PV-IHVC anastomosis.

Conclusions

Modified MCA can rapidly anastomose the SHVC, enhance the success rate of LT, lower the difficulty and cycle of exercise for beginners and establish an ideal LT model.

图1 大鼠供肝SHVC的磁环安装及IHVC、PV套管
图2 大鼠肝移植供受体血管吻合
表1 实验前中后期大鼠肝移植各阶段手术时间(min,±s
表2 大鼠肝移植手术失败原因分析(例)
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