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

胃肠道节段常用于膀胱扩大术(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不断接触时，BA术后各种明显的并发症，如尿石症、代谢性酸中毒、膀胱穿孔、粘液生成增加和肿瘤，都可能发生。为了克服BA术后使用肠道组织相关的并发症，我们开发了一种新的BA实验技术，并在大鼠身上进行了测试：活体相关部分膀胱移植(LPBTx)。短期结果非常令人鼓舞，我们计划了一系列新的刘易斯大鼠的长期结果，重点放在新生大鼠的致癌风险上。大鼠活体部分膀胱移植(lpb…)膀胱隆大术后的长期组织病理学变化比较常规回肠膀胱成形术与回肠膀胱成形术(TX)的疗效。BA后10mo存活的大鼠，经血液生化和新膀胱造影术后处死。取膀胱行苏木精-伊红染色和增殖细胞核抗原检测。当大鼠被处死时，ICP大鼠明显小于LPBTx大鼠。LPBTx组平均血清pH为7.41±0.78，ICP组为7.25±0.38。ICP组的平均碱基过剩显著低于LPBTx组。LPBTx组膀胱结石发生率(6.3%)明显低于ICP组(33.3%)。LPBTx组未见异型增生/恶性/增殖细胞核抗原表达增加。与对照组相比，肝内胆汁淤积症大鼠肝组织中有2例(16.7%)有核细胞异型增生。与对照组相比，LPBTx组和ICP组的膀胱容量增加。我们希望证明使用LPBTx的BA可以产生比使用ICP的BA更少的并发症；LPBTx也可以降低恶变的风险。较少

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