Zhang Shigeng, Gao Fei, Xue Chong, Zhang Nan, Gao Feng, Li Shaojiang, Wen Jiaming
Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China.
Int Urol Nephrol. 2017 Feb;49(2):255-261. doi: 10.1007/s11255-016-1475-9. Epub 2016 Dec 16.
To evaluate the feasibility and possibility of wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial ureter external scaffold to prevent stoma stenosis in rabbit after ureterocutaneostomy.
Forty male New Zealand rabbits were involved in this study. For application of ureterocutaneostomy, the right ureter was wrapped by a pedicled gastrocolic omentum flap and combined with application of an artificial external scaffold, which served as experimental side. Traditional ureterocutaneostomy was applied in left ureter (control side). All rabbits were killed after 1 month, and the kidney, ureter and abdominal segment ureter were collected to study the morphological and pathological changes by using HE staining, Masson staining, immunohistochemistry staining and microvessel density (MVD) study.
HE staining showed that renal medullary tubular dilatation, large number of collagen deposition, renal glomerular and renal tubular atrophy. Glomerular vascular leaves and interstitial fibrosis were detected in the kidney of control side. However, these abnormities in the kidney of experimental side were significantly alleviated compared to control side. The hydronephrosis and ureterectasia in the experimental side were dramatically attenuated compared to control side. Fibrosis in ureter around stoma and stoma stenosis were prevented by wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold.
In this study, we have demonstrated that wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold is capable of preventing stoma stenosis in rabbit after ureterocutaneostomy, which provided a new method and theoretical basis for clinical application in the future.
评估带蒂胃结肠网膜瓣包裹输尿管并联合人工输尿管外支架预防兔输尿管皮肤造口术后造口狭窄的可行性和可能性。
40只雄性新西兰兔参与本研究。行输尿管皮肤造口术时，右侧输尿管采用带蒂胃结肠网膜瓣包裹并联合应用人工外支架，作为实验组。左侧输尿管行传统输尿管皮肤造口术（对照组）。1个月后处死所有兔子，取肾、输尿管及腹部段输尿管，采用苏木精-伊红染色（HE染色）、Masson染色、免疫组织化学染色及微血管密度（MVD）检测等方法研究其形态学和病理学变化。
HE染色显示，实验组肾髓质肾小管扩张，大量胶原沉积，肾小球及肾小管萎缩。对照组肾脏可见肾小球血管叶及间质纤维化。然而，实验组肾脏的这些异常与对照组相比明显减轻。实验组的肾积水和输尿管扩张较对照组明显减轻。带蒂胃结肠网膜瓣包裹输尿管并联合人工外支架可预防造口周围输尿管纤维化及造口狭窄。
本研究表明，带蒂胃结肠网膜瓣包裹输尿管并联合人工外支架能够预防兔输尿管皮肤造口术后造口狭窄，为今后临床应用提供了新的方法和理论依据。
