Ammirati M, Rao L N, Murthy M S, Buchmann T, Goldschmidt R A, Scanlon E F
Department of Surgery, Evanston Hospital, Illinois 60201.
J Surg Oncol. 1989 Jul;41(3):153-9. doi: 10.1002/jso.2930410305.
We have developed a surgical model to perform partial nephrectomy in mice using the milliwatt CO2 laser and have used this model for studying the influence of the sequel of surgery on experimental tumor metastasis. Strain A mice were subjected to partial nephrectomy using the milliwatt CO2 laser. The surgical procedure was time efficient, the blood loss was minimal, and the postoperative mortality was 6%. Immediately after surgery, the wound consisted of a superficial layer of charring and a deeper layer of thermal damage (coagulative necrosis). The wound healing was completed within 30 days and was accompanied by fibroblast infiltration and tubular regeneration but minimal inflammatory response. Seventy surgical mice were injected I.V. with TA3Ha murine mammary adenocarcinoma cells at different intervals (immediately to 30 days) after surgery. Among 38 mice inoculated with tumor cells immediately or up to 3 days after surgery, 18 (47%) showed histologically confirmed tumors at the site of surgical trauma. None of the 38 unoperated kidneys showed any evidence of tumor. This difference is statistically significant at a P value of less than 0.001. As the interval between surgery and tumor inoculation was increased to 7, 15, and 30 days, the frequency of tumor formation at the site of surgery decreased to 20% (2/10), 14% (2/14), and 0% (0/8), respectively. The results demonstrate that a) partial nephrectomy in mice is feasible with minimal mortality or apparent morbidity, b) the laser-induced surgical trauma favors implantation and growth of tumors, c) the frequency of tumor formation is related to the stage of wound healing, and d) the tumors are anatomically related to the healing wound but do not invade into the parenchymal tissue.
我们开发了一种使用毫瓦级二氧化碳激光在小鼠身上进行部分肾切除术的手术模型，并利用该模型研究手术后遗症对实验性肿瘤转移的影响。选用A品系小鼠，使用毫瓦级二氧化碳激光进行部分肾切除术。该手术操作效率高，出血量极少，术后死亡率为6%。手术后即刻，伤口由表层碳化和较深层的热损伤（凝固性坏死）组成。伤口在30天内愈合，伴有成纤维细胞浸润和肾小管再生，但炎症反应轻微。70只接受手术的小鼠在术后不同时间间隔（即刻至30天）经静脉注射TA3Ha小鼠乳腺腺癌细胞。在术后即刻或术后3天内接种肿瘤细胞的38只小鼠中，18只（47%）在手术创伤部位经组织学证实有肿瘤。38只未手术的肾脏均未显示任何肿瘤迹象。这种差异在P值小于0.001时具有统计学意义。随着手术与肿瘤接种之间的时间间隔增加到7天、15天和30天，手术部位肿瘤形成的频率分别降至20%（2/10）、14%（2/14）和0%（0/8）。结果表明：a）小鼠部分肾切除术可行，死亡率或明显发病率极低；b）激光诱导的手术创伤有利于肿瘤的植入和生长；c）肿瘤形成的频率与伤口愈合阶段有关；d）肿瘤在解剖学上与愈合伤口相关，但不侵入实质组织。
