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首页> 外文期刊>BMC Urology >Comparison of Yang-Monti ileal ureter-bladder anastomosis versus Yang-Monti ileal ureter-ureteral anastomosis for the treatment of ureteral stenosis: a randomized controlled trial in a miniature pig model
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Comparison of Yang-Monti ileal ureter-bladder anastomosis versus Yang-Monti ileal ureter-ureteral anastomosis for the treatment of ureteral stenosis: a randomized controlled trial in a miniature pig model

机译：杨蒙西髂骨输尿管囊吻合与杨蒙西患者输尿管吻合术治疗输尿管狭窄的术 - 一种微型猪模型的随机对照试验

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The aim of the present study was to establish an animal model of Yang-Monti ileal ureter-bladder anastomosis and Yang-Monti ileal ureter-ureteral anastomosis and compare the advantages and disadvantages of the two surgical methods. Fourteen 12-month-old male Chinese miniature pigs weighing 21?±?1.38?kg were randomly divided into two groups. Group A (n?=?7) underwent end-to-end anastomosis of the left Yang-Monti ileal ureter, left ileal ureter and left lower ureter; group B (n?=?7) underwent anastomosis of the left Yang-Monti ileal ureter, left ileal ureter and bladder. In both groups, the contralateral kidney was removed at 1?week postoperatively. The incision length and operation time of the two groups were compared. Changes in serum creatinine and urea nitrogen were observed preoperatively, and at 2, 6 and 12?weeks postoperatively. Venous pyelography and cystography were performed at 12?weeks postoperatively to determine the ureteral patency and vesicoureteral reflux. At 12?months postoperatively, urinary culture was performed, and the diameter and histological changes of the intestinal ureter were assessed. Surgery was successfully completed in all 14 pigs. In group A, one pig died due to an anesthetic accident, and one pig died from a lung infection on postoperative day 4. In group B, one pig died from adhesive intestinal obstruction on postoperative day 7. The overall survival rate was 78.6%, and the 11 surviving pigs had no urinary or intestinal fistulae. Compared with group B, group A had a significantly longer surgical incision (30.86?±?2.41?cm versus 26.71?±?3.64?cm; p?=?0.01) and shorter operation time (181.29?±?15.10?min versus 157.71?±?20.49?min; p?=?0.02). The serum creatinine and urea nitrogen concentrations did not significantly differ between groups. All pigs had normal renal function pre- and postoperatively. There was no stenosis or obstruction on venous pyelography. The narrowest diameter of the ureter was significantly smaller in group B (5.90?±?0.30?mm) than in group A (7.26?±?1.06?mm; p?=?0.01), but no contrast agent returned to the upper urinary tract in either group. Escherichia coli was detected on urine culture. In group A, one pig had obstruction of the ureteral ureter, while another had stenosis of the lower ureteral anastomosis. In group B, one pig had pelvic and intestinal ureteral dilatation; however, all anastomoses were patent. The ileal ureteral diameter was significantly larger in group A (9.40?±?2.35?mm) than group B (6.62?±?0.37?mm; p?=?0.02). Two pigs in group A had separation of the transitional epithelium and columnar epithelial mucosa, with granulation tissue hyperplasia. The pigs with stenosis and obstruction had smooth fibrous tissue and smooth muscle of the anastomosis. In both groups, the two types of epithelial tissue were close together, and the intestinal villi were mildly atrophied and shortened. An animal model of Yang-Monti ileal ureter-bladder anastomosis was successfully established. Compared with Yang-Monti ileal ureter-ureteral anastomosis, Yang-Monti ileal ureter-bladder anastomosis is simpler, more reliable, and results in fewer complications.
机译：本研究的目的是建立阳蒙蒂患者疱疹膀胱吻合术和阳蒙西患者输尿管吻合术的动物模型，并比较两种手术方法的优缺点。十四个12个月大的男性中式微型猪称重21？±1.38？kg随机分为两组。 A组（n？=α7）接受左阳蒙蒂患者患者的端到端吻合术，左肠输尿管和左下输尿管; B组（n？=β7）接受左阳蒙蒂肠输尿管的吻合术，留下肠输尿管和膀胱。在这两组中，在术后1个星期内除去对侧肾脏。比较了两组的切口长度和操作时间。术前观察血清肌酐和尿素氮的变化，并在术后2,6和12？周期。静脉肾盂造影和胱造影在术后12次进行，以确定输尿管通畅和血清学的回流。术后12个月，进行尿培养，评估肠输尿管的直径和组织学变化。手术成功完成了所有14只猪。在A组中，一只猪由于麻醉事故而死亡，一只猪从术后第4天从肺部感染死亡。在B组中，一只猪在术后第7天从粘合剂肠梗阻死亡。总生存率为78.6％，并且11个存活的猪没有尿或肠瘘。与B组相比，A组具有明显更长的手术切口（30.86？±2.2.41？cm与26.71？3.64？cm; p？=？0.1）和更短的操作时间（181.29？±15.10？min与157.71 ？±20.49？min; p？= 0.02）。组血清肌酐和尿素氮浓度在基团之间没有显着差异。所有猪都有正常的肾功能预先垂直。静脉肾盂造影没有狭窄或障碍物。除了A组（7.26？±0.30.3.06？mm; p？= 0.01）中，B组（5.90？±0.30Ω·0.30Ωmm）中最窄的输尿管直径明显较小在任一组中的道。在尿培养上检测到大肠杆菌。在A组中，一只猪阻塞了输尿管输尿管，而另一只猪患有较低输尿管吻合术的狭窄。在B组中，一只猪骨盆和肠道输尿管扩张;然而，所有吻合术都是专利。 A组（9.40≤x≤2.35Ω·2.35Ω·±2.35Ω·±0.37Ω·mm; p？= 0.02），Ileal输尿管直径明显更大。 A组中的两只猪具有过渡性上皮和柱状上皮粘膜的分离，肉芽组织增生。具有狭窄和障碍物的猪具有光滑的纤维组织和吻合术的平滑肌。在这两组中，两种类型的上皮组织都在一起，肠绒毛温和地萎缩并缩短。成功建立了阳蒙西肠疱疹囊肿吻合术的动物模型。与杨蒙蒂患者输尿管吻合术相比，阳蒙蒂患者胃窦吻合吻合术更简单，更可靠，并导致并发症较少。

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