■小鼠原位肺移植(LTx)模型在肺移植中具有巨大的研究价值。本研究比较了小鼠LTx的两种吻合方法(前后肺门吻合)的难度,操作时间,和术后效果。
■20只小鼠接受滑结LTx进行前肺门吻合术(AH组),和28接受LTx用微血管夹进行后肺门吻合术(PH组),都是一个外科医生干的.记录手术时间,术后24小时评估移植物。
■受体动物的成功率在AH组为85%(17/20),在PH组为89%(25/28)(P>0.05)。AH组的受体手术时间和回台时间长于PH组(52.8±5.0比47.3±5.7分钟,27.8±3.9vs25.3±2.8分钟,P<.05),但是热缺血时间没有显着差异(13.1±2.1vs12.2±2.6分钟,P=.258),这意味着时间上的差异主要来自于肺门治疗。在AH组中,2例分别于LTx后24小时因肺静脉血栓形成和肺不张失败,但PH组没有失败。成功受者的术后表现无明显差异(胸片,宏观外观,氧合指数,肺顺应性,病理变化)。
■与前肺门吻合术相比,采用微血管夹的后肺门吻合术在处理肺门结构时复杂性较低,耗时较少,术后并发症较少。
UNASSIGNED: The mouse orthotopic lung transplantation (LTx) model is of enormous research value in lung transplantation. This study compares 2 anastomotic methods (anterior and posterior hilum anastomosis) of mouse LTx in term of difficulty, operation time, and postoperative effects.
UNASSIGNED: Twenty mice received LTx with slipknots for anterior hilum anastomosis (AH group), and 28 received LTx with a microvessel clip for posterior hilum anastomosis (PH group), all by a single surgeon. The operation time was recorded and the grafts were evaluated 24 hours after surgery.
UNASSIGNED: The success rates in the recipient animals were 85% (17/20) in AH group and 89% (25/28) in PH group (P > .05). The recipient operation time and back table time in AH group were longer than those in PH group (52.8 ± 5.0 vs 47.3 ± 5.7 minutes, 27.8 ± 3.9 vs 25.3 ± 2.8 minutes, P < .05), but the warm ischemia time did not differ significantly (13.1 ± 2.1 vs 12.2 ± 2.6 minutes, P = .258), meaning that the time discrepancies predominantly originated from the hilum treatment. In AH group, 2 cases failed due to pulmonary venous thrombosis and atelectasis respectively at 24 hours after LTx, but none failed in PH group. No significant difference was observed in the postoperative performance of the successful recipients (thoracic radiographs, macroscopic appearance, oxygenation index, pulmonary compliance, pathologic changes) between the 2 groups.
UNASSIGNED: Compared with anterior hilar anastomosis, posterior hilum anastomosis with a microvessel clip is less complicated and less time-consuming in the management of hilar structures and causes fewer postoperative complications.