Pommergaard Hans-Christian, Achiam Michael Patrick, Rosenberg Jacob
Department of Surgical Gastroenterology D, Herlev Hospital, Center for Perioperative Optimization, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark,
Surg Today. 2014 May;44(5):933-9. doi: 10.1007/s00595-013-0632-3. Epub 2013 Jun 9.
Colon anastomotic leakage remains a serious and common surgical complication. Animal models are valuable to determine the pathophysiological mechanisms and to evaluate possible methods of prevention. The aim of this study was to develop an optimal model of clinical colon anastomotic leakage in a technically insufficient anastomosis in the mouse.
A total of 110 mice were used in three pilot studies (1-3) and two experiments (A, B). Due to the high complication rates, the analgesic regimen and surgical techniques were changed throughout the pilot studies/experiments. In the final successful experiment (B), eight and four absorbable sutures were used in the control and intervention anastomoses, respectively, and buprenorphine in chocolate spread was used for pain treatment.
In the final model (experiment B), significantly more animals in the intervention group had clinical anastomotic leakage compared with controls (40 vs. 0 %, p = 0.003). The weight loss was greater and the wellness score was also lower in these animals (p < 0.001). The breaking strength of the anastomoses was not significantly different between the control group [0.55 N ± 0.09] and intervention group [0.49 N ± 0.15] (p = 0.091).
This mouse model closely mimics clinical colon anastomotic leakage in humans. The model is of high clinical relevance, since anastomotic leakage has a similar cause, incidence and manifestations in humans.
结肠吻合口漏仍然是一种严重且常见的手术并发症。动物模型对于确定病理生理机制和评估可能的预防方法具有重要价值。本研究的目的是在小鼠技术上不充分的吻合术中建立一种最佳的临床结肠吻合口漏模型。
在三项预实验（1 - 3）和两项实验（A、B）中总共使用了110只小鼠。由于并发症发生率高，在整个预实验/实验过程中改变了镇痛方案和手术技术。在最终成功的实验（B）中，对照组和干预组的吻合分别使用了8根和4根可吸收缝线，并使用巧克力酱中的丁丙诺啡进行疼痛治疗。
在最终模型（实验B）中，干预组出现临床吻合口漏的动物明显多于对照组（40%对0%，p = 0.003）。这些动物的体重减轻更大，健康评分也更低（p < 0.001）。对照组[0.55 N ± 0.09]和干预组[0.49 N ± 0.15]之间吻合口的断裂强度无显著差异（p = 0.091）。
该小鼠模型紧密模拟了人类临床结肠吻合口漏。该模型具有高度的临床相关性，因为吻合口漏在人类中有相似的原因、发生率和表现。
