Ren Zhangyong, Cui Songping, Lyu Shaocheng, Wang Jing, Zhou Lin, Jia Yanan, He Qiang, Lang Ren
Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Front Surg. 2022 Sep 9;9:984959. doi: 10.3389/fsurg.2022.984959. eCollection 2022.
With the advancement of vascular anastomosis techniques in recent years, radical surgery for tumors combined with venous vascular resection and reconstruction has been widely used. This study intends to establish two different rat vein replacement models, and further analyze the pathological changes of blood vessels after replacement.
Brown-Norway (BN) rats were selected as donors and recipients, randomly divided into control group, cuff group (1-week group, 2-week group, and 4-week group), and suture group (1-week group, 2-week group, and 4-week group), with 6 rats in each group. The perioperative conditions, inner diameter, flow velocity and histopathological changes of the replaced vessels at different time points were analyzed.
Both cuff group and suture group can safely establish the rat vein replacement model. From the surgical operation, the operation time and venous cross-clamp time in the cuff group were shorter than those in the suture group ( < 0.05). At 2 and 4 weeks after operation, the diameter of suture group was wider than that of cuff group, and the flow rate was faster ( < 0.05). With prolonged postoperative survival, the wall of the replaced vessels underwent infiltration of CD4+ and CD8+ lymphocytes and high TGF-β1 gene expression. This leads to the proliferation of blood vessels and intimal layer. The results of vascular pathological staining showed that the infiltration degree of CD4+ lymphocytes at 2 weeks after operation and CD8+ lymphocytes at 4 weeks after operation in the suture group was lighter than that in the cuff group ( < 0.05). Meanwhile, TGF-β1 gene content at 4 weeks after operation in suture group was significantly lower than that in cuff group ( < 0.05).
Compared with cuff method, suture method is more suitable for the study of long-term pathological changes after vein replacement in rats. The main pathological changes in the long term after venous replacement in syngeneic background may be vascular fibrosis caused by inflammatory cell infiltration.
近年来随着血管吻合技术的进步,肿瘤根治性手术联合静脉血管切除重建已被广泛应用。本研究旨在建立两种不同的大鼠静脉置换模型,并进一步分析置换后血管的病理变化。
选取棕色挪威(BN)大鼠作为供体和受体,随机分为对照组、袖套组(1周组、2周组和4周组)和缝合组(1周组、2周组和4周组),每组6只大鼠。分析不同时间点置换血管的围手术期情况、内径、流速及组织病理学变化。
袖套组和缝合组均能成功建立大鼠静脉置换模型。从手术操作来看,袖套组的手术时间和静脉阻断时间均短于缝合组(P<0.05)。术后2周和4周时,缝合组血管直径较袖套组宽,流速更快(P<0.05)。随着术后存活时间延长,置换血管壁出现CD4+和CD8+淋巴细胞浸润以及TGF-β1基因高表达。这导致血管和内膜层增生。血管病理染色结果显示,缝合组术后2周CD4+淋巴细胞浸润程度及术后4周CD8+淋巴细胞浸润程度均轻于袖套组(P<0.05)。同时,缝合组术后4周TGF-β1基因含量显著低于袖套组(P<0.05)。
与袖套法相比,缝合法更适合用于研究大鼠静脉置换术后的长期病理变化。同基因背景下静脉置换术后长期的主要病理变化可能是炎性细胞浸润导致的血管纤维化。