Reconstruction of injured autonomic nerves in the abdominal and pelvic spaces.

1)腹下神经的自发重建：犬腹下神经部分切除（2.5 cm）后4年，刺激腰内脏神经（LSN）可引起输精管、膀胱颈和前列腺收缩。2）切断的自主神经的再连接：（1）切断犬腹下神经后18个月，刺激大鼠的坐骨神经可引起输精管、膀胱颈和前列腺的收缩。结果表明，从LSN到靶器官的多条交叉通路被重建。再接后的重建率高于未再接者。(2)切断的盆神经远端再附着后，刺激其近端产生膀胱收缩。容量充足，残余尿少。(3)自体膀胱移植伴盆神经复位成功。容量充足，残余尿少，排尿反射保留。3）自主神经移植：将腹下神经或生殖股神经移植到盆神经缺损处，刺激盆神经引起膀胱收缩。容量充足，残余尿少。4）自主神经移植：腹下神经与盆神经吻合后，从脊髓开始，经坐骨神经、腹下神经，建立盆神经和盆丛至盆内靶器官。5）对再附着部位神经的组织学研究表明自主神经再生。6）神经移植在临床上应用于腹膜后交感神经系统。结果令人鼓舞。

1) Spontaneous reconstruction of the hypogastric nerve : Four years after partial removal (2.5 cm) of the canine hypogastric nerve, stimulation of the lumbar splanchnic nerve (LSN) generated contractions of the vas deferens, bladder neck and prostate. The multiple crossed pathways from the LSN to the target organs were also demonstrated to be reconstructed spontaneously.2) Reattachment of the transected autonomic nerves :(1) Eighteen months after reattachment of transected canine hypogastric nerve : stimulation of the LSN elicited contractions of the vas deferens, bladder neck and prostate. The multiple crossed pathways from the LSN to the target organs were demonstrated to be reconstructed. The rate of reconstruction by reattachment was higher than that without reattachment.(2) After reattachment of transected pelvic nerve at its distal end, stimulation of its proximal end generated bladder contraction. The capacity was sufficient and residual urine was little.(3) Auto-transplantation of the bladder accompanied with pelvic nerve reattachment succeeded. The capacity was sufficient, residual urine little, and voiding reflex was preserved. Our results indicated that reconstruction of the transected pelvic nerve occurs within 9 months after reattachment.3) Autonomic nerve graft : After grafting the hypogastric nerve or the genitofemoral nerve into the defect of the pelvic nerve, stimulation of the pelvic nerve elicited bladder contraction. The capacity was sufficient and residual urine was little.4) Autonomic nerve-transfer : After anastomosis of the hypogastric nerve with the pelvic nerve, the pathway from the spinal cord, passing through the LSN, hypogastric nerve, pelvic nerve and pelvic plexus to the intrapelvic target organs were constructed.5) Histological study of the nerve at the site reattached demonstrated regeneration of the autonomic nerve.6) Nerve graft was clinically applied in retroperitoneal sympathetic nervous system. The result was promising.