Anorectal autotransplantation in a canine model: the first successful report in the short term with the non-laparotomy approach.
Anorectal autotransplantation in a canine model: the first successful report in the short term with the non-laparotomy approach.
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DOI：
10.1038/srep06312
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发表时间：
2014-09-10
影响因子：
4.6
通讯作者：
Koshima I
中科院分区：
文献类型：
--
作者：
Araki J;Nishizawa Y;Nakamura T;Sato T;Naito M;Hatayama N;Hirai S;Tashiro K;Koshima I
结肠造口术是肛门功能障碍的常规治疗方法。最近，一些动物肛门直肠移植试验已被公布为结肠造口的潜在替代方案;然而，需要进一步发展这项技术。在这项研究中，我们利用了犬肛门直肠移植模型，评估了显微外科吻合的通畅性，并评估了移植肛门的灌注。我们设计了一种犬肛门直肠移植模型，其中4只健康Beagle犬通过直肠下段、双侧阴部动脉（PA）和阴部静脉（PVs）以及阴部神经（PNs）的闭塞进行肛门直肠自体移植。术后通过吲哚菁绿色（ICG）血管造影和组织学检查测量移植物灌注。包括肛周皮肤、肛门括约肌、双侧PA、PV和PN在内的肛管直肠移植物的长度为4.9 ± 0.3 cm。 肺动脉、肺静脉和肺静脉的所有直径都足够大，可以在显微镜下观察到。ICG血管造影和组织学检查均显示良好的移植物灌注，除了1例导致静脉充血。这些结果表明，吻合双侧PA，PV和PN是肛门直肠移植所必需的。本研究为首例犬自体肛门直肠移植成功的报道。
Colostomy is conventional treatment for anal dysfunction. Recently, a few trials of anorectal transplantation in animals have been published as a potential alternative to colostomies; however, further development of this technique is required. In this study, we utilized a canine model of anorectal transplantation, evaluated the patency of our microsurgical anastomoses, and assessed the perfusion of the transplanted anus. We designed a canine anorectal transplantation model, wherein anorectal autotransplantation was performed in four healthy beagle dogs by anastomoses of the lower rectum, the bilateral pudendal arteries (PAs) and veins (PVs), and pudendal nerves (PNs). Postoperative graft perfusion was measured by indocyanine green (ICG) angiography and histological examination. The length of the anorectal graft including perianal skin, anal sphincter muscle, bilateral PAs, PVs, and PNs was 4.9 ± 0.3 cm. All diameters of the PAs, PVs, and PNs were large enough to be microscopically anastomosed. Both ICG angiography and histological examination demonstrated good graft perfusion, except for one case that lead to venous congestion. These results show that anastomosis of the bilateral PAs, PVs, and PNs is required for anorectal transplantation. This is the first successful report of canine anorectal autotransplantation.
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