Lamas S, Azuara D, de Oca J, Sans M, Farran L, Alba E, Escalante E, Rafecas A
Department of Surgery, Hospital Universitari de Bellvitge-Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Barcelona, Spain.
Dis Esophagus. 2008;21(4):370-6. doi: 10.1111/j.1442-2050.2007.00772.x.
Apoptosis, necrosis and neovascularization are three processes that occur during ischemic preconditioning in a range of organs. In the stomach, the effect of this preconditioning (the delay phenomenon) has helped to improve gastric vascularization prior to esophagogastric anastomosis after esophagectomy. Here we present a sequential study of the histological recovery of the gastric fundus and the phenomena of apoptosis, necrosis and neovascularization in an experimental model of partial gastric ischemia. Partial gastric devascularization was performed by ligature of the left gastric vessels in Sprague-Dawley rats. Rats were assigned to groups in accordance with their evaluation period: control, 1, 3, 6, 10, 15 and 21 days. Histological analysis, caspase-3 activity, DNA fragmentation and vascular endothelial cell proliferation (Ki-67) were measured in tissue samples after sacrifice. After 24 h of partial gastric ischemia, rates of apoptosis and necrosis were higher in the experimental groups than in controls. Tissue injury was higher 3 and 6 days post-ischemia. From day 10 after partial gastric ischemia, apoptosis and necrosis started to decrease, and on days 15 and 21 showed no differences in relation to controls. Neovascularization began between days 1 and 3, reaching its peak at 15 days after ischemia and coinciding with complete histological recovery. Both necrosis and apoptosis play a role in tissue injury during the first days after partial gastric ischemia. After 15 days, the evolution of both the histology and the neovascularization suggested that this is the optimal time for performing gastric transposition.
细胞凋亡、坏死和新血管形成是一系列器官在缺血预处理过程中发生的三个过程。在胃中，这种预处理的效果（延迟现象）有助于在食管切除术后食管胃吻合术前改善胃血管化。在此，我们展示了一项关于胃底组织学恢复以及部分胃缺血实验模型中细胞凋亡、坏死和新血管形成现象的序贯研究。通过结扎Sprague-Dawley大鼠的胃左血管来进行部分胃去血管化。根据评估期将大鼠分为对照组、1天、3天、6天、10天、15天和21天组。处死大鼠后，对组织样本进行组织学分析、半胱天冬酶-3活性、DNA片段化和血管内皮细胞增殖（Ki-67）检测。部分胃缺血24小时后，实验组的细胞凋亡率和坏死率高于对照组。缺血后3天和6天组织损伤更严重。部分胃缺血后第10天起，细胞凋亡和坏死开始减少，在第15天和21天与对照组无差异。新血管形成在第1天至第3天开始，在缺血后15天达到峰值，与组织学完全恢复同时发生。坏死和细胞凋亡在部分胃缺血后的头几天均在组织损伤中起作用。15天后，组织学和新血管形成的演变表明这是进行胃移位的最佳时间。
