Gao Peigen, Li Chongwu, Ning Ye, Wu Junqi, Zhang Pei, Liu Xiucheng, Su Yiliang, Zhao Deping, Chen Chang
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Shanghai Engineering Research Center of Lung Transplantation, Shanghai, China.
Ann Transl Med. 2022 Jun;10(12):673. doi: 10.21037/atm-22-2018.
Although orthotopic single lung transplantation in rats has long been established, this model is still highly challenging. Therefore, we made several modifications in anesthesia, lung extraction, vascular clamp, and transplantation procedures for this model.
Fifty cases of rat left lung transplantation were performed using traditional procedures and modified surgical techniques, respectively. Two hundred Sprague Dawley male rats, half as donors and half as recipients, were randomized equally to the two groups. The modifications included orotracheal intubation via a video laryngoscope, retrograde perfusion following anterograde perfusion, a Rummel tourniquet for the occlusion of pulmonary vessels, flushing the vessels and cuffs before anastomosis with heparin, and a simple pleural drainage. The surgical time, warm and cold ischemia time, vascular complications, and survival rate on postoperative day seven were compared between the two groups.
The modified surgical techniques significantly reduced the surgical duration (35.7 46.3 min, P<0.01), warm ischemia time (16.3 28.8 min, P<0.01), and vascular complications (2% 16%, P=0.04). Moreover, the survival rate on postoperative day 7 was higher in the improved surgical techniques group (96% 80%, P=0.03).
We described the improvement of surgical techniques for orthotopic single lung transplantation in rats, which could shorten anastomoses time, reduce vascular complications, and improve survival rate.
尽管大鼠原位单肺移植早已确立,但该模型仍极具挑战性。因此,我们对该模型的麻醉、肺提取、血管钳夹及移植程序进行了多项改进。
分别采用传统程序和改良手术技术进行50例大鼠左肺移植。200只雄性Sprague Dawley大鼠,一半作为供体,一半作为受体,随机均分为两组。改进措施包括通过视频喉镜进行经口气管插管、顺行灌注后逆行灌注、用鲁梅尔止血带阻断肺血管、在吻合前用肝素冲洗血管和袖带以及简单的胸腔引流。比较两组的手术时间、热缺血和冷缺血时间、血管并发症以及术后第7天的生存率。
改良手术技术显著缩短了手术时间(35.7对46.3分钟,P<0.01)、热缺血时间(16.3对28.8分钟,P<0.01)和血管并发症(2%对16%,P=0.04)。此外,改良手术技术组术后第7天的生存率更高(96%对80%,P=0.03)。
我们描述了大鼠原位单肺移植手术技术的改进,可缩短吻合时间、减少血管并发症并提高生存率。