Ghahramani Leila, Jahromi Ali Bagherpour, Dehghani Mohammad Reza, Ashraf Mohammad Javad, Rahimikazerooni Salar, Rezaianzadeh Abbas, Safarpour Ali Reza, Hosseini Seyed Vahid
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Adv Biomed Res. 2014 Apr 17;3:113. doi: 10.4103/2277-9175.131029. eCollection 2014.
There is a growing tendency toward application of human amniotic membrane (HAM) as a biologic substitute in various tissue injuries where a significant tissue loss is a matter of concern. In gastrointestinal injuries especially duodenal ones, some potential limitations in current surgical techniques contribute to not fully acceptable healing outcomes. Thus, this study was carried out to assess repair with HAM patch for duodenal defect in comparison with simple duodenoraphy in an animal model (dog).
A total of 15 male German shepherd dogs weighing 23-27 kg were randomly divided into two groups. Group A with 10 dogs, which were a candidate for duodenal repair by amniotic membrane patch and Group B consisted of 5 dogs perform simple duodenorraphy. A precise control was made to match all conditions except surgical technique. Macroscopic and microscopic features of the healed duodenal lumen in both groups were recorded.
Gross evaluation revealed no difference in luminal diameter in both groups. Statistical analysis of duodenal diameter between both groups after operation also showed no significant difference (P v = 0.789). Histological assessment indicated less inflammation with better wound healing in Group A.
It seems that repairing duodenal wall defect with HAM would result in better histological outcomes compared with what is seen in simple duodenoraphy in animal models. However, there is no significant difference regarding surgical findings.
在各种存在明显组织缺损的组织损伤中,将人羊膜(HAM)用作生物替代品的应用趋势日益增长。在胃肠道损伤尤其是十二指肠损伤中,当前手术技术存在一些潜在局限性,导致愈合效果不尽人意。因此,本研究旨在通过动物模型(犬)比较HAM补片修复十二指肠缺损与单纯十二指肠缝合术的效果。
总共15只体重23 - 27千克的雄性德国牧羊犬被随机分为两组。A组有10只犬,采用羊膜补片进行十二指肠修复;B组由5只犬组成,进行单纯十二指肠缝合术。除手术技术外,对所有条件进行精确控制。记录两组愈合后十二指肠腔的宏观和微观特征。
大体评估显示两组管腔直径无差异。术后两组十二指肠直径的统计分析也显示无显著差异(P 值 = 0.789)。组织学评估表明,A组炎症较轻,伤口愈合较好。
与动物模型中的单纯十二指肠缝合术相比,用HAM修复十二指肠壁缺损似乎能带来更好的组织学结果。然而,手术结果方面无显著差异。