Gardikis Stefanos, Giatromanolaki Alexandra, Ypsilantis Petros, Botaitis Sotiris, Perente Sabach, Kambouri Aikaterini, Efstathiou Eleftheria, Antypas Spyros, Polychronidis Alexandros, Touloupidis Stavros, Sivridis Efthimios, Simopoulos Constantinos
Department of Paediatric Surgery, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
Eur Urol. 2005 Mar;47(3):417-21. doi: 10.1016/j.eururo.2004.10.014. Epub 2004 Dec 2.
To determine the most suitable type of graft-free penile skin grafts or mucosal grafts from bladder or buccal regions - for urethral reconstruction in an animal model, as evaluated on the basis of angiogenic activity.
Twenty-two male White New Zealand rabbits were randomly divided into four groups. In the control group (group O, n=4) a simple urethrotomy and closure was performed, whereas a ventral urethral defect was created in groups A, B, and C and then bridged using the following onlay patches: free penile skin (group A, n=6), buccal mucosal graft (group B, n=6), and bladder mucosal graft (group C, n=6). On the 21st postoperative day, the animals were sacrificed and the retrieved implants were subjected to macroscopic and microscopic analysis. The angiogenic activity was assessed with immunohistochemistry, using the anti-CD31 MoAb and the phosphatase antialkaline phosphatase procedure. The native vascularity of penile skin as well as buccal and bladder mucosa was assessed in rabbits from group O (n=3). Statistical analysis was performed using the one-way ANOVA.
The angiogenesis in a magnification of x200 in groups O, A, B, and C was 34.1+/-4.1 (mean+/-SD), 61.7+/-6.4, 94.3+/-6.4, and 91.5+/-7.2 vessels per optical field, respectively. There were, statistically significant differences (p<0.001) between groups A and B and between groups A and C, but not (p>0.05) between groups B and C. The native vascularity of penile skin, buccal mucosa and bladder mucosa was 23.3+/-3.0, 24.6+/-3.7 and 17.0+/-2.6 vessels per optical field, respectively.
The viability of mucosal grafts from bladder or buccal regions is better than that of a free penile graft because of higher angiogenic activity. Although the mucosal grafts showed the same angiogenic activity, the buccal mucosa graft is preferable because of its easier harvesting.
在动物模型中，基于血管生成活性评估，确定最适合用于尿道重建的无移植阴茎皮肤移植物或来自膀胱或颊部区域的黏膜移植物类型。
将22只雄性新西兰白兔随机分为四组。对照组（O组，n = 4）行单纯尿道切开术并缝合，而在A、B、C组制造腹侧尿道缺损，然后使用以下覆盖补片进行桥接：游离阴茎皮肤（A组，n = 6）、颊黏膜移植物（B组，n = 6）和膀胱黏膜移植物（C组，n = 6）。术后第21天，处死动物，对取出的植入物进行宏观和微观分析。使用抗CD31单克隆抗体和抗碱性磷酸酶磷酸酶法，通过免疫组织化学评估血管生成活性。在O组（n = 3）的兔子中评估阴茎皮肤以及颊部和膀胱黏膜的天然血管分布。使用单因素方差分析进行统计分析。
在放大200倍时，O、A、B、C组每视野的血管生成分别为34.1±4.1（平均值±标准差）、61.7±6.4、94.3±6.4和91.5±7.2条血管。A组与B组之间以及A组与C组之间存在统计学显著差异（p < 0.001），但B组与C组之间无差异（p > 0.05）。阴茎皮肤、颊黏膜和膀胱黏膜的天然血管分布分别为每视野23.3±3.0、24.6±3.7和17.0±2.6条血管。
由于更高的血管生成活性，来自膀胱或颊部区域的黏膜移植物的活力优于游离阴茎移植物。尽管黏膜移植物显示出相同的血管生成活性，但由于颊黏膜移植物更容易获取，因此更可取。
