Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.
PLoS One. 2013;8(3):e58903. doi: 10.1371/journal.pone.0058903. Epub 2013 Mar 29.
Recently, vagus nerve preservation or reconstruction of vagus has received increasing attention. The present study aimed to investigate the feasibility of reconstructing the severed vagal trunk using an autologous sural nerve graft.
Ten adult Beagle dogs were randomly assigned to two groups of five, the nerve grafting group (TG) and the vagal resection group (VG). The gastric secretion and emptying functions in both groups were assessed using Hollander insulin and acetaminophen tests before surgery and three months after surgery. All dogs underwent laparotomy under general anesthesia. In TG group, latency and conduction velocity of the action potential in a vagal trunk were measured, and then nerves of 4 cm long were cut from the abdominal anterior and posterior vagal trunks. Two segments of autologous sural nerve were collected for performing end-to-end anastomoses with the cut ends of vagal trunk (8-0 nylon suture, 3 sutures for each anastomosis). Dogs in VG group only underwent partial resections of the anterior and posterior vagal trunks. Laparotomy was performed in dogs of TG group, and latency and conduction velocity of the action potential in their vagal trunks were measured. The grafted nerve segment was removed, and stained with anti-neurofilament protein and toluidine blue.
Latency of the action potential in the vagal trunk was longer after surgery than before surgery in TG group, while the conduction velocity was lower after surgery. The gastric secretion and emptying functions were weaker after surgery in dogs of both groups, but in TG group they were significantly better than in VG group. Anti-neurofilament protein staining and toluidine blue staining showed there were nerve fibers crossing the anastomosis of the vagus and sural nerves in dogs of TG group.
Reconstruction of the vagus nerve using the sural nerve is technically feasible.
最近，迷走神经的保留或重建越来越受到关注。本研究旨在探讨使用自体腓肠神经移植重建切断的迷走神经干的可行性。
10 只成年比格犬随机分为两组，每组 5 只，神经移植组（TG）和迷走神经切除组（VG）。两组在术前和术后 3 个月均采用 Hollander 胰岛素和对乙酰氨基酚试验评估胃分泌和排空功能。所有犬均在全身麻醉下接受剖腹手术。在 TG 组，测量迷走神经干的动作电位潜伏期和传导速度，然后从腹部前、后迷走神经干切取 4cm 长的神经。采集两段自体腓肠神经，与切断的迷走神经干端进行端端吻合（8-0 尼龙缝线，每吻合口 3 针）。VG 组仅行前、后迷走神经干部分切除。TG 组行剖腹探查，测量其迷走神经干的动作电位潜伏期和传导速度。切除移植神经段，用抗神经丝蛋白和甲苯胺蓝染色。
TG 组术后迷走神经干动作电位潜伏期较术前延长，传导速度较术前降低。术后两组犬胃分泌和排空功能减弱，但 TG 组明显优于 VG 组。抗神经丝蛋白染色和甲苯胺蓝染色显示，TG 组犬的迷走神经和腓肠神经吻合处有神经纤维穿过。
使用腓肠神经重建迷走神经在技术上是可行的。
