基于反观面“钟摆式”吻合法的小鼠左肺原位移植改良模型（附视频）

李偲涵; 黄桁; 王俊杰; 唐宏涛; 吴野; 侯森林; 刘沛直; 杨菀; 陈婷婷; 张圣璇; 付思怡; 左玉洁; 杨俊杰; 严浩吉; 田东

doi:10.3969/j.issn.1674-7445.2022.05.013

基于反观面“钟摆式”吻合法的小鼠左肺原位移植改良模型（附视频）

doi: 10.3969/j.issn.1674-7445.2022.05.013

637000 四川南充，川北医学院附属医院心肺移植研究室

基金项目:

四川省医学会青年创新科研课题 Q21040

南充市杰出青年科技人才专项 20SXJCQN0002

川北医学院附属医院科研发展计划项目 2021ZK003

2021年四川省大学生创新创业训练计划项目 202110634060

详细信息

作者简介:

通讯作者:
田东，博士，副教授，研究方向为肺移植基础与临床研究，Email：TianD_EATTS@nsmc.edu.cn

中图分类号: R617, R563
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出版历程
- 收稿日期: 2022-04-02
- 网络出版日期: 2022-09-14
- 刊出日期: 2022-09-15

A modified mouse model of orthotopic left lung transplantation based on "pendulum" anastomosis of the reverse-view plane (with video demonstration)

Heart and Lung Transplant Research Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

More Information

Corresponding author: Tian Dong, Email: TianD_EATTS@nsmc.edu.cn

摘要

摘要: 目的本研究从多角度对小鼠左肺原位移植模型进行改进，旨在建立一种更简易、快速和稳定的小鼠肺移植研究模型。方法基于本团队前期大鼠左肺原位肺移植改良模型，本研究对小鼠左肺原位移植的气管插管、套管制备和受体吻合程序等均进行了不同程度的改进。由1名具有显微外科经验的操作者连续进行40例小鼠左肺原位移植手术。其中，受体肺门结构的游离在肺门钳夹平面的反观面视野下进行，并采用“钟摆式”吻合法依次对肺门三支（左主支气管、肺动脉、肺静脉）逐一吻合。详细记录各移植程序的操作时间。于术后2周处死受体，记录术后并发症的发生情况。结果 40例小鼠肺移植手术均成功完成，术中无支气管和血管撕裂、扭曲，吻合处无渗血。心肺整体获取时间为（10.7±1.5）min，套管制备时间为（16.2±1.5）min，冷缺血时间为（25.1±2.4）min，热缺血时间为（19.4±1.6）min，总手术时间为（57.2±2.9）min。在术后6~14 d的随访过程中，1只受体小鼠死于胸腔积液，考虑为感染所致；其余受体小鼠随访期间均未出现气胸、血栓和肺不张等现象。结论本研究基于反观面“钟摆式”吻合法的小鼠左肺原位移植改良模型具有操作时间短、成功率高和并发症少等优点，有望成为可供选择的肺移植术后病理变化的研究模型，值得进一步推广。
- 肺移植 /
- 小鼠 /
- 肺移植模型 /
- 反观面 /
- 供肺套管 /
- 切口方式 /
- “钟摆式”吻合 /
- 热缺血时间 /
- 冷缺血时间
Abstract: Objective To modify the mouse model of orthotopic left lung transplantation from different perspectives, aiming to establish a simpler, faster and stabler mouse model of lung transplantation. Methods Based on preliminary modified rat model of orthotopic left lung transplantation established by our team, varying extent of modifications were made regarding the tracheal intubation, cannula preparation and anastomosis procedures of orthotopic left lung transplantation in the recipient mice. Orthotopic left lung transplantation in 40 mice were performed by an operator with microsurgical experience. The dissection of the recipient's hilar structure was carried out at the plane of the hilar clamp model within the reverse-view, and the three branches (left main bronchus, pulmonary artery and pulmonary vein) of the pulmonary hilum were anastomosed in turn by the "pendulum" anastomosis method. The operation time of each procedure was recorded. The recipient mice were sacrificed at postoperative 2 weeks, and the incidence of postoperative complications was recorded. Results Lung transplantation was successfully completed in 40 mice, with no bronchial and vascular tearing or twisting, and no bleeding at the anastomosis site. The overall cardiopulmonary procurement time was (10.7±1.5) min, cannula preparation time was (16.2±1.5) min, cold ischemia time was (25.1±2.4) min, warm ischemia time was (19.4±1.6) min, and the total operation time was (57.2±2.9) min, respectively. During the follow-up from 6 to 14 days after surgery, one recipient mouse died of pleural effusion, probably caused by infection. No pneumothorax, thrombosis or atelectasis was found in the remaining recipient mice during postoperative follow-up. Conclusions The modified mouse model of orthotopic left lung transplantation based on "pendulum" anastomosis of the reverse-view plane possesses multiple advantages of short operation time, high success rate and few complications, which is expected to become an alternative model of studying pathological changes after lung transplantation and worthy of further application.
- Lung transplantation /
- Mouse /
- Lung transplantation model /
- Reverse-view plane /
- Donor lung cannula /
- Incision mode /
- "Pendulum" anastomosis /
- Warm ischemia time /
- Cold ischemia time

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图 1 小鼠左肺原位移植手术步骤

注：A图为牵拉膈肌暴露下腔静脉；B图为供肺套管制备；C图为肺门三支切口形状及位置，肺动脉做" T " 形切口，肺静脉和支气管分叉处做"∧"形切口（操作者俯视视角）；D图为肺门三支吻合完成。PA为肺动脉，PV为肺静脉，Br.为支气管。

Figure 1. Surgical procedures for orthotopic left lung transplantation in mice

下载: 全尺寸图片幻灯片

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