Foell Daniel, Becker Felix, Hadrian Rebecca, Palmes Daniel, Kebschull Linus
Division of Experimental Surgical Research, Department of General and Visceral Surgery, University Hospital of Muenster, Muenster, Germany.
Division of Experimental Surgical Research, Department of General and Visceral Surgery, University Hospital of Muenster, Muenster, Germany.
J Surg Res. 2017 Jun 1;213:115-130. doi: 10.1016/j.jss.2017.02.026. Epub 2017 Mar 16.
Animal models are a central aspect in research on small bowel transplantation (SBTx). Among them, rats are the preferred species because of their widespread availability and cost effectiveness. Because the complexity of the surgical procedure could per se influence the outcome of an experiment, a standardized and comparable technique is important. Based on of the vast amount of different models and surgical techniques published to this point, a review seemed necessary to guide investigators when choosing the suitable model.
A systematic literature search of original articles published between 1965 and 2016 using the Medline Database regarding techniques of SBTx in rats was conducted according to the Preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles describing a new technique or evaluating different techniques were considered.
A total of 38 publications fulfilled the selection criteria and were included. Data from these publications were regarded as too heterogeneous for statistical analysis. Depending on graft length and placement, full-length and reduced length heterotopic and orthotopic models were differentiated. Important factors concerning a good survival rate are the chosen model (heterotopic has a better outcome compared with orthotopic), a vascular flush of the graft in situ, a careful luminal flush of the graft, adequate fluid resuscitation, and a warm ischemia time of less than 40 min.
SBTx in rats remains a complex and challenging procedure, which necessitates a standardized technique as well as sufficient training. By choosing the optimal experimental model, applying established strategies, and proven techniques, a standardized and scientifically reliable model can be achieved.
动物模型是小肠移植（SBTx）研究的核心内容。其中，大鼠因其广泛可得性和成本效益而成为首选物种。由于手术操作的复杂性本身可能会影响实验结果，因此标准化且具有可比性的技术很重要。鉴于目前已发表的大量不同模型和手术技术，进行一次综述对于指导研究人员选择合适的模型似乎很有必要。
根据系统评价和Meta分析的首选报告项目指南，使用Medline数据库对1965年至2016年间发表的关于大鼠SBTx技术的原始文章进行了系统的文献检索。考虑了描述新技术或评估不同技术的文章。
共有38篇出版物符合入选标准并被纳入。这些出版物的数据被认为过于异质，无法进行统计分析。根据移植物长度和放置方式，区分了全长和缩短长度的异位和原位模型。与良好存活率相关的重要因素包括所选模型（异位模型的结果优于原位模型）、移植物原位血管冲洗、移植物管腔仔细冲洗、充分的液体复苏以及小于40分钟的热缺血时间。
大鼠SBTx仍然是一个复杂且具有挑战性的手术，需要标准化技术以及充分的训练。通过选择最佳实验模型、应用既定策略和经过验证的技术，可以实现标准化且科学可靠的模型。
