Department of Pediatric Surgery, Ruprecht-Karls University, Heidelberg, Germany.
J Surg Res. 2011 Dec;171(2):709-18. doi: 10.1016/j.jss.2011.07.052. Epub 2011 Aug 25.
Because of anatomical and physiological similarities to humans, porcine small bowel transplantation (SBTx) can be used as an appropriate experimental model in the field of surgical research. Various approaches to SBTx have been described in literature. The aim of this work is to present a review of different surgical techniques of SBTx which have been developed using the porcine model. Our analysis of Medline-cited studies dealing with different techniques of SBTx in porcine models was particularly focused on surgical aspects. With regard to graft procurement and enterectomy, the reported techniques vary widely. Arterial reconstruction is mainly conducted by performing the anastomosis between the superior mesenteric artery (SMA) of the donor and SMA or infrarenal aorta of the recipient. Alternatively, an aortic segment of the donor can be anastomosed to the infrarenal aorta of the recipient. Venous anastomosis is frequently performed between the superior mesenteric vein (SMV) of the donor and SMV or the inferior vena cava (IVC) of the recipient. Some studies also report venous anastomosis between the portal vein of the donor and the recipient. Bowel continuity is then restored by end-to-end or end-to-side anastomosis. Remarkable results were generated thanks to improved techniques which include proximal side-to-side ileo-ileal anastomosis with double-barrel ileostomy, or so-called "Paul-Mikulicz-Ileostomy". Most frequently used were jejunostomy and the "Bishop-Koop-Ileostomy"--where the proximal part of the bowel is anastomosed end-to-side to the distal part, which is then exteriorized as an ostomy. Based on the techniques presented in this review, one must select the most suitable surgical technique of porcine SBTx among those various models.
由于与人类在解剖学和生理学上的相似性，猪小肠移植（SBTx）可用作外科研究领域的合适实验模型。文献中已经描述了各种 SBTx 方法。本文旨在介绍已在猪模型中开发的不同 SBTx 手术技术的综述。我们对涉及不同猪模型 SBTx 技术的 Medline 引用研究进行了分析，特别关注手术方面。关于移植物的获取和肠切除术，报告的技术差异很大。动脉重建主要通过在供体的肠系膜上动脉（SMA）和受体的 SMA 或肾下主动脉之间进行吻合来完成。或者，可以将供体的主动脉段吻合到受体的肾下主动脉。静脉吻合通常在供体的肠系膜上静脉（SMV）和受体的 SMV 或下腔静脉（IVC）之间进行。一些研究还报告了供体门静脉和受体之间的静脉吻合。然后通过端端吻合或端侧吻合恢复肠连续性。由于改进的技术，产生了显著的结果，这些技术包括带有双套管回肠造口术的近端侧侧回肠-回肠吻合术，或所谓的“Paul-Mikulicz 回肠造口术”。最常用的是空肠造口术和“Bishop-Koop 回肠造口术”——将肠的近端部分端侧吻合到远端部分，然后将其作为造口外置。基于本文介绍的技术，必须在这些不同的模型中选择最适合的猪 SBTx 手术技术。
