Living-related Partial Bladder Transplantation for Bladder Augmentation : An Experimental Study

胃肠道段通常用于膀胱扩大术（BA），以治疗神经源性膀胱或膀胱外翻患者。然而，当胃肠道组织与尿液持续接触时，可能发生各种显著的BA后并发症，如尿石症、代谢性酸中毒、膀胱穿孔、粘液产生增加和肿瘤。特别是，任何可能的风险，恶性肿瘤的肠段用于BA是一个问题的严重concerning.To克服后BA并发症与使用肠组织，我们开发了一种新的实验技术BA，我们在大鼠中进行了测试：活体相关的部分膀胱移植（LPBTx）。短期结果非常令人鼓舞，我们计划在一系列新的刘易斯大鼠中进行长期结果，重点关注新膀胱的致癌风险。大鼠活体部分膀胱移植（LPB）膀胱扩大（BA）后的长期组织病理学变化 ...更多信息 比较了Tx）或传统回膀胱成形术（ICP）。在血液生化和新膀胱成像后，将BA后存活>10个月的大鼠处死。用苏木精-伊红染色和增殖细胞核抗原（PCNA）检查收获的膀胱。当大鼠被处死时，ICP大鼠明显小于LPBTx大鼠。LPBTx组的平均血清pH为7.41±0.78，ICP组为7.25±0.38。ICP组的平均碱过量显著低于LPBTx组。LPBTx组膀胱结石的发生率（6.3%）显著低于ICP组（33.3%）。在LPBTx组中没有异型增生/恶性肿瘤/PCNA增加。ICP组的PCNA增加，与对照组相比，两个（16.7%）ICP大鼠12有核分裂异常。与对照组相比，LPBTx和ICP的膀胱容量增加。我们希望表明，使用LPBTx的BA可能导致新膀胱，并发症比使用ICP的BA少; LPBTx也可能降低恶性肿瘤的风险。少

Segments of gastrointestinal tract are commonly used for bladder augmentation (BA) to treat patients with neurogenic bladder or bladder exstrophy. However, when gastrointestinal tissue is in constant contact with urine, various significant post-BA complications, such as urolithiasis, metabolic acidosis, bladder perforation, increased mucous production, and tumor, can develop. In particular, any possible risk for malignancy in the intestinal segment used for BA is a matter of grave concern.To overcome post-BA complications associated with using enteric tissue, we developed a novel experimental technique for BA, which we tested in rats: living-related partial bladder transplantation (LPBTx). The short-term results were very encouraging and we planed the long-term results in a new series of Lewis rats, focusing on the risk for carcinogenesis in the neobladder.Long-term histopathologic changes after bladder augmentation (BA) in rats using living-related partial bladder transplantation (LPB … More Tx) or conventional ileocystoplasty (ICP) were compared. Rats that survived >10 mo after BA were killed after blood biochemistry and neobladder imaging. Harvested bladders were examined with hematoxylin and eosin and proliferating cell nuclear antigen (PCNA). When the rats were killed, ICP rats were significantly smaller than LPBTx rats. Mean serum pH in the LPBTx group was 7.41±0.78 and in the ICP group was 7.25±0.38. Mean base excess in the ICP group was significantly lower than in the LPBTx group. Incidence of bladder calculi in the LPBTx group (6.3%) was significantly lower than in the ICP group (33.3%). There was no dysplasia/malignancy/increase in PCNA in the LPBTx group. PCNA increased in the ICP group, compared with controls ; two (16.7%) of 12 of ICP rats had dysplasia with mitosis. Bladder capacity increased in LPBTx and ICP compared with controls. We hope to show that BA using LPBTx may result in a neobladder with fewer complications than BA using ICP ; LPBTx may also decrease the risk for malignancy. Less