Ames Caroline D, Vanlangendonck Richard, Morrissey Kevin, Venkatesh Ramakrishna, Landman Jaime
Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.
Urology. 2005 Aug;66(2):451-4. doi: 10.1016/j.urology.2005.03.033.
To evaluate the utility of the porcine and canine models for collecting system closure after partial nephrectomy involving violation of the renal collecting system. Advanced surgical technologies and novel techniques for performing laparoscopic partial nephrectomy are frequently evaluated in an animal model.
After evaluation of the upper urinary tract with retrograde pyelography, laparoscopic partial nephrectomy, including violation of the renal collecting system, was performed in 8 domestic pigs (group 1) and 2 dogs (group 2) with documented normal upper urinary tract physiology. No collecting system closure was performed. Subsequently, in an attempt to generate an adequate model for renal collecting system closure, 6 pigs (group 3) underwent partial obstruction of the proximal ureter before laparoscopic partial nephrectomy without collecting system closure. After 3 weeks, the animals underwent evaluation, including retrograde pyelography, and were killed for histopathologic evaluation of the upper urinary tracts.
Despite documented transection of major calices in all animals, none with physiologically normal upper urinary tracts developed urinomas. After partial occlusion of the proximal ureter, all pigs had hydronephrosis, but only one of six developed a urinoma.
The porcine and canine models are inadequate for evaluating renal collecting system closure after partial nephrectomy. Our high-pressure partial occlusion model was similarly inadequate. The limitations of these animal models should be considered when reviewing published data regarding technologies for partial nephrectomy. Future data regarding novel technologies for partial nephrectomy should also be carefully considered before clinical application.
评估猪和犬模型在涉及肾集合系统损伤的部分肾切除术后收集系统闭合方面的效用。先进的外科技术和进行腹腔镜部分肾切除术的新技术经常在动物模型中进行评估。
在通过逆行肾盂造影评估上尿路后，对8头家猪（第1组）和2只犬（第2组）进行腹腔镜部分肾切除术，包括损伤肾集合系统，这些动物的上尿路生理功能记录正常。未进行集合系统闭合。随后，为了建立一个合适的肾集合系统闭合模型，6头猪（第3组）在腹腔镜部分肾切除术前行近端输尿管部分梗阻，未进行集合系统闭合。3周后，对动物进行评估，包括逆行肾盂造影，然后处死进行上尿路组织病理学评估。
尽管所有动物均记录有大盏横断，但上尿路生理功能正常的动物均未发生尿瘤。近端输尿管部分闭塞后，所有猪均出现肾积水，但6头猪中只有1头发生尿瘤。
猪和犬模型不足以评估部分肾切除术后肾集合系统的闭合情况。我们的高压部分闭塞模型同样不适用。在回顾关于部分肾切除术技术的已发表数据时，应考虑这些动物模型的局限性。在临床应用之前，也应仔细考虑关于部分肾切除术新技术的未来数据。
