Nilay Tutak Fatma, Annaç Ebru
Adiyaman University, School of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Turkey.
Adiyaman University, School of Medicine, Department of Histology and Embriyology, Adiyaman, Turkey.
Ann Med Surg (Lond). 2021 Sep 25;70:102861. doi: 10.1016/j.amsu.2021.102861. eCollection 2021 Oct.
Mesenchymal Stem Cells (MSCs) are well known for their tissue regeneration enhancing effect and their contribution to immune regulation. However, their contribution to the healing process of femoral artery anastomosis, especially to endothelialization, has not been studied sufficiently in the clinic. This study was carried out to evaluate the effects of MSC-lyophilisate from the human umbilical cord on anastomosis experimental study in rats histopathologically.
After intraperitoneal anesthesia was applied to the rats, the femoral artery was exposed with a 2 cm incision in the right femoral region. After the artery was cut in the experiment and sham groups, femoral artery end-to-end anastomosis was performed using the primary suture technique. MSC-lyophilisate was poured in powder form onto the anastomosed outer surface of the vessel in the treatment group and saline solution was poured to the sham group. No intervention was made to the control group. The data analysis was performed with IBM SPSS Statistics 25.
In the experiment group, flattening of the inner elastic lamina, morphological changes and vacuolization in the muscle fibers, inflammation in the adventitia and significant vascular wall thickening were observed in the femoral arteries of the rats after the intervention. According to the histopathological scoring results, tissue samples belonging to sham and experimental groups showed marked pathological findings such as endothelial damage, flattened areas where the folded structure in the inner elastic lamina disappeared, muscle fiber degeneration and inflammation in the adventitia.
Human umbilical cord-origin MSC-lyophilisate application holds an important place in femoral artery surgery. We evaluate that it will be meaningful to determine the MSC-lyophilisate dose for hemostasis without creating thrombus after anastomosis. MSC-lyophilisate will be used to provide hemostasis in areas with local bleeding in the future. In addition, it is recommended to make plans for an in-depth examination of possible problems and cases in future studies.
间充质干细胞（MSCs）以其促进组织再生及对免疫调节的作用而闻名。然而，其在股动脉吻合口愈合过程中的作用，尤其是对内皮化的作用，在临床上尚未得到充分研究。本研究旨在通过组织病理学方法评估人脐带间充质干细胞冻干制剂对大鼠吻合口实验研究的影响。
对大鼠进行腹腔麻醉后，在右股部做一个2厘米的切口，暴露股动脉。在实验组和假手术组切断动脉后，采用端端缝合技术进行股动脉吻合。治疗组将冻干制剂粉末状倒在血管吻合的外表面，假手术组倒入生理盐水。对照组不做干预。使用IBM SPSS Statistics 25进行数据分析。
干预后，实验组大鼠股动脉内弹性膜变平、肌纤维出现形态学改变和空泡化、外膜炎症以及血管壁明显增厚。根据组织病理学评分结果，假手术组和实验组的组织样本均显示出明显的病理表现，如内皮损伤、内弹性膜折叠结构消失的扁平区域、肌纤维变性和外膜炎症。
人脐带源间充质干细胞冻干制剂在股动脉手术中占有重要地位。我们认为确定吻合术后不形成血栓的止血用间充质干细胞冻干制剂剂量具有重要意义。间充质干细胞冻干制剂未来将用于局部出血区域的止血。此外，建议在未来研究中针对可能出现的问题和病例制定深入检查计划。
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