Kambouri K, Gardikis S, Giatromanolaki A, Efstathiou E, Pitiakoudis M, Ipsilantis P, Botaitis S, Perente S, Antypas S, Polychronidis A, Sivridis E, Simopoulos C
Department of Paediatric Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, 43 G. Papandreou Street, 68100 Alexandroupolis, Greece.
Eur J Pediatr Surg. 2006 Oct;16(5):323-8. doi: 10.1055/s-2006-924601.
An experimental study was undertaken in order to estimate the angiogenic activity in different free grafts and pedicle flap in urethral reconstruction in an animal model.
Twenty-eight white New Zealand rabbits were randomly divided into five groups (O, A, B, C and D). A ventral urethral defect was created in all groups. In the group O, (n = 4), a simple closure of the defect was performed. Free penile skin graft (group A, n = 6), buccal mucosal graft (group B, n = 6), bladder mucosal graft (group C, n = 6), and pedicle penile skin graft (group D, n = 6) were used to bridge the urethral defect as an onlay patch. The animals were euthanized on the 21st postoperative day. The angiogenic activity was assessed with immunohistochemistry, using the anti-CD31 MoAb and the alkaline 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 one-way ANOVA.
The angiogenesis seen with a magnification of x 200 in groups O, A, B, C, and D was 34.1 +/- 4.1 (mean +/- SD), 61.7 +/- 6.4, 94.3 +/- 6.4, 91.5 +/- 7.2, and 30.8 +/- 5.2 vessels per optical field, respectively. There were statistically significant differences (p < 0.001) between group O and groups A, B, C and between group A and groups B, C, D, but not (p > 0.5) between groups B and C and groups O and D. 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.
Buccal and bladder mucosal grafts exhibit a higher angiogenic activity than free and pedicle penile skin flap when transplanted in urethral defects. As the buccal mucosal graft showed the higher angiogenic activity and its harvesting is easier than bladder mucosa, we propose that in urethral reconstruction surgery the use of this graft might offer more reliable results.
进行一项实验研究，以评估在动物模型中不同游离移植物和带蒂皮瓣用于尿道重建时的血管生成活性。
将28只白色新西兰兔随机分为五组（O、A、B、C和D）。所有组均制造腹侧尿道缺损。在O组（n = 4）中，对缺损进行简单缝合。游离阴茎皮肤移植物（A组，n = 6）、颊黏膜移植物（B组，n = 6）、膀胱黏膜移植物（C组，n = 6）和带蒂阴茎皮肤移植物（D组，n = 6）被用作覆盖补片来桥接尿道缺损。动物在术后第21天安乐死。使用抗CD31单克隆抗体和碱性磷酸酶抗碱性磷酸酶方法，通过免疫组织化学评估血管生成活性。在O组（n = 3）的兔中评估阴茎皮肤以及颊黏膜和膀胱黏膜的固有血管分布。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和D组每个视野的血管生成数量分别为34.1±4.1（平均值±标准差）、61.7±6.4、94.3±6.4、91.5±7.2和30.8±5.2条血管。O组与A、B、C组之间以及A组与B、C、D组之间存在统计学显著差异（p < 0.001），但B组与C组之间以及O组与D组之间无统计学差异（p > 0.5）。阴茎皮肤、颊黏膜和膀胱黏膜的固有血管分布分别为每个视野23.3±3.0、24.6±3.7和17.0±2.6条血管。
当移植到尿道缺损处时，颊黏膜和膀胱黏膜移植物比游离和带蒂阴茎皮瓣表现出更高的血管生成活性。由于颊黏膜移植物显示出更高的血管生成活性且其获取比膀胱黏膜更容易，我们建议在尿道重建手术中使用这种移植物可能会提供更可靠的结果。
