Stone Elizabeth Arnold, Robertson John L, Metcalf Michael R
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
Vet Surg. 2002 Jul-Aug;31(4):391-7. doi: 10.1053/jvet.2002.33595.
To determine whether bisection or intersegmental nephrotomy adversely affects glomerular filtration rate (GFR) and whether bisection nephrotomy has less adverse effect than intersegmental nephrotomy.
Dogs assigned to 5 groups of 3 dogs each, depending on time of euthanasia at postoperative day 1, 4, 8, 15, or 29.
Fifteen healthy adult intact female dogs.
Within 4 days of total and single kidney GFR measurements using technetium Tc 99m-DTPA, left intersegmental nephrotomy and right bisection nephrotomy were performed. The GFR measurements were repeated the day before dogs were killed except for the day 1 group. Histologic examination was performed on kidneys harvested from day 1, 4, 8, and 29 groups. Severity of lesions was scored on a 0 to 4 scale. Single kidney GFR was compared in each kidney before and after nephrotomy. Histologic and GFR changes were compared between bisection and intersegmental nephrotomy kidneys for each time period.
Three days after surgery, total GFR was increased from baseline by 176%, with no difference in percent change in single kidney GFR between intersegmental and bisection nephrotomy. By day 7, total and single kidney GFR were not different than baseline. Bisection nephrotomy caused more intrarenal hemorrhage and cortical infarction and inflammation than intersegmental nephrotomy. By 4 weeks, no significant histologic differences were observed between the 2 techniques.
Neither intersegmental nor bisection nephrotomy adversely affected GFR. As intersegmental nephrotomy requires additional surgical manipulation and time, bisection nephrotomy is the technique of choice for nephrotomy in dogs.
确定二分法肾切开术或节段间肾切开术是否会对肾小球滤过率(GFR)产生不利影响,以及二分法肾切开术的不良影响是否小于节段间肾切开术。
根据术后第1、4、8、15或29天安乐死的时间,将狗分为5组,每组3只。
15只健康成年未绝育雌性狗。
在使用锝Tc 99m - DTPA测量全肾和单肾GFR的4天内,进行左节段间肾切开术和右二分法肾切开术。除第1组外,在狗处死前一天重复进行GFR测量。对从第1、4、8和29组采集的肾脏进行组织学检查。病变严重程度按0至4分评分。比较肾切开术前、后每个肾脏的单肾GFR。比较每个时间段二分法和节段间肾切开术肾脏的组织学和GFR变化。
术后3天,全肾GFR较基线增加176%,节段间肾切开术和二分法肾切开术单肾GFR的变化百分比无差异。到第7天,全肾和单肾GFR与基线无差异。二分法肾切开术比节段间肾切开术引起更多的肾内出血、皮质梗死和炎症。到4周时,两种技术之间未观察到明显的组织学差异。
节段间肾切开术和二分法肾切开术均未对GFR产生不利影响。由于节段间肾切开术需要额外的手术操作和时间,二分法肾切开术是犬肾切开术的首选技术。