摘要
目的比较磁吻合技术(MCA)与传统缝合吻合犬门静脉的组织学差异。方法选择健康中华田园犬18只,雌雄不限,月龄8~12个月,体重13.5~18.9 kg。电脑编号后随机分为MCA组(n=9,切断门静脉,利用磁吻合环行端端吻合)和手工缝合组(n=9,切断门静脉再手工缝合)。比较两组门静脉吻合时间。吻合即刻和术后4、8、12、24周取吻合口标本行HE染色、Masson染色,扫描与透射电镜观察吻合口超微结构。结果所有实验犬手术后均健康存活。MCA组门静脉吻合时间(3.58±2.75)min,少于手工缝合组(12.89±3.12)min,差异有统计学意义(P<0.05)。MCA组术后即刻肉眼见吻合口血管壁对位整齐,手工缝合组褶皱明显。术后24周电镜观察MCA组吻合口内皮细胞排列整齐,形态规则,手工缝合组吻合口内皮细胞呈褶皱样,排列和形态紊乱。HE染色MCA组术后24周无明显炎症反应,Masson染色纤维组织较少。手工缝合组吻合口因缝线残留,术后24周HE染色吻合口仍可见炎症反应,Masson染色可见局部纤维组织增生明显。结论MCA吻合犬门静脉较传统手工缝合时间更短,吻合口内膜光滑,无明显纤维组织增生,血管无异物残留,炎症反应轻微,吻合口质量更好。MCA无缝线吻合犬门静脉效果可靠。
Objective To compare the histological differences between magnetic anastomosis and traditional suture in canine portal vein(PV).Methods Eighteen healthy Chinese garden dogs,either gender,8-12 months and weighing 13.5-18.9 kg,were randomly divided into magnetic compressive anastomats(MCA)group(n=9)and hand-sewing(HS)group(n=9)for PV reconstruction.The time of PV anastomosis was compared between the two groups.HE and Masson staining were performed immediately and at 4,8,12 and 24 weeks after operation.The ultrastructure of the anastomosis was observed using scanning and transmission electron microscopy.Results All dogs survived.The PV anastomosis time was significantly shorter in MCA group(3.58±2.75)min than that HS group(12.89±3.12)min,P<0.01.In MCA group,the vascular wall of anastomotic stoma was well aligned immediately after operation,and the shrinkage was obvious in HS group by gross eyes.At 24 weeks,electron microscope scanning showed the re-endothelialization was smooth and endothelial cells arranged regularly at the anastomotic site of the MCA group,whereas different-sized and irregularly aligned endothelial cells and large collagenous fibers arranged in disorder were present at the HS anastomotic stoma.Representative HE and Masson staining confirmed that the magnetic device was associated with decreased infiltration of inflammatory cells and deposition of fibrotic collagen at 24 weeks explanted anastomotic stomas compared with the HS group.Conclusions Compared with the HS,MCA produced shorter anastomosis time,smooth anastomotic intima,light fibrous tissue hyperplasia,no foreign body residue,mild inflammatory reaction and reliable technique for canines PV anastomosis.
作者
刘仕琪
吕毅
宋宇龙
王善佩
白纪刚
Liu Shiqi;Lyu Yi;Song Yulong;Wang Shanpei;Bai Jigang(Department of Neonatal Surgery,Xi’an Children's Hospital,Shaanxi Institute for Pediatric Diseases,Xi’an Key Laboratory of Children’s Health and Diseases,Xi’an 710003,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China;Department of Anesthesiology,Shaanxi Provincial People's Hospital,Xi’an 710068,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2021年第2期139-143,共5页
Chinese Journal of Hepatobiliary Surgery
基金
国家自然科学基金(81470896、30830099)
陕西省重点产业创新链(群)-社会发展领域项目(2020ZDLSF02-03)。
关键词
门静脉
磁吻合技术
无缝线吻合
犬
Portal vein
Magnetic compression anastomosis
Sutureless anastomosis
Canine
