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猪模型中的颅极点肾切除术:三维内铸型分析动脉损伤。

Cranial pole nephrectomy in the pig model: anatomic analysis of arterial injuries in tridimensional endocasts.

机构信息

Urogenital Research Unit, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

J Endourol. 2012 Jun;26(6):716-21. doi: 10.1089/end.2011.0489. Epub 2012 Feb 21.

Abstract

PURPOSE

To assess the intrarenal arteries injuries after cranial pole nephrectomy in a pig model to compare these findings with those in humans.

MATERIALS AND METHODS

Polyester resin was injected through the ureter and the renal artery to make three-dimensional casts of 61 pig kidneys. The cranial pole of the kidneys was sectioned at four different sites before the solidification of the resin, and the casts were examined for arterial damage.

RESULTS

Section performed through the hilus (15 kidneys): The cranial division of the renal artery was sectioned in two (13.33%) cases, the ventral branch of the cranial division of the renal artery was sectioned in 13 (86.7%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 11 (73.34%) cases. Section at 0.5 cm cranial to the hilus (16 kidneys): The cranial division of the renal artery was sectioned in 1 (6.25%) case, the ventral branch of the cranial division of the renal artery was sectioned in 14 (87.5%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 13 (81.25%) cases. Section at 1.0 cm cranial to the hilus (15 kidneys): The ventral branch of the cranial division of the renal artery was sectioned in five (33.33%) cases, and the dorsal branch of the cranial division of the renal artery was injured in five (33.33%) cases. Section at 1.5 cm cranial to the hilus (15 kidneys): No lesions were found in the main arteries, only in the interlobular branches.

CONCLUSIONS

As previously demonstrated in humans, sections at 1.0 cm or more cranially to the hilus in pigs also showed a significant decrease in damage to the major intrarenal arteries. Therefore, as regards arterial damage, the pig kidney is a useful model for partial nephrectomy in the cranial (upper) pole.

摘要

目的

评估猪模型中颅极肾切除术后肾内动脉损伤情况,并与人类进行比较。

材料与方法

通过输尿管和肾动脉注入聚酯树脂,使 61 个猪肾的三维模型凝固。在树脂凝固前,在四个不同部位对肾的颅极进行分段,检查动脉损伤情况。

结果

在肾门处进行的 15 个肾脏分段:肾动脉的颅部分支在 2 个(13.33%)病例中被切断,肾动脉颅部分支的腹侧分支在 13 个(86.7%)病例中被切断,肾动脉颅部分支的背侧分支在 11 个(73.34%)病例中被切断。在肾门上方 0.5cm 处进行的 16 个肾脏分段:肾动脉的颅部分支在 1 个(6.25%)病例中被切断,肾动脉颅部分支的腹侧分支在 14 个(87.5%)病例中被切断,肾动脉颅部分支的背侧分支在 13 个(81.25%)病例中被切断。在肾门上方 1.0cm 处进行的 15 个肾脏分段:肾动脉颅部分支的腹侧分支在 5 个(33.33%)病例中被切断,肾动脉颅部分支的背侧分支在 5 个(33.33%)病例中受损。在肾门上方 1.5cm 处进行的 15 个肾脏分段:主要动脉无损伤,仅发现小叶间分支损伤。

结论

与人类先前的研究结果一致,在猪模型中,在肾门上方 1.0cm 或以上处进行的分段也显著减少了主要肾内动脉的损伤。因此,就动脉损伤而言,猪肾是颅极(上部)部分肾切除术的有用模型。

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