Patricolo M, Noia G, Rossi L, Zangari A, Pomini F, Catesini C, Filippetti R, Galli T, Iacobelli B D, Capuano L G, Romano D, Mancuso S, Rivosecchi M
Department of Pediatric Surgery, Ospedale Pediatrico Bambino Gesù, Rome.
Fetal Diagn Ther. 1998 Sep-Oct;13(5):298-301. doi: 10.1159/000020857.
To obtain 'intestinal atresia-like' conditions in the fetal lamb model to subsequently allow in utero surgical repair.
Six time-dated pregnant sheep underwent general anesthesia at 75 days of gestation (term 145 +/- 5 days). After maternal laparotomy and hysterotomy, the fetal abdomen was opened. Once the jejunoileal intestinal loop was identified, the mesenteric vessels were isolated, ligated, and sectioned in 2 fetuses, and in the remaining 5 fetuses the bowel loop was ligated. Two further fetuses were used as controls and underwent sole laparotomy. Of the group of 7 fetuses 2 were reoperated at 100-105 days of gestational age and underwent intestinal recanalization. Eight fetuses were delivered at term by cesarean section and the remaining 1 by spontaneous delivery. One newborn underwent neonatal entero-enteric anastomosis.
4 out of 6 fetuses survived, in utero intestinal or vascular ligation having provoked an 'intestinal atresia-like' picture. The animal operated at birth died. The 2 control fetuses and the 2 fetuses with in utero intestinal recanalization survived until term.
The present study shows that in utero treatment of intestinal obstruction is possible in an experimental model.
在胎羊模型中获得“肠闭锁样”情况，以便随后进行宫内手术修复。
6只确定孕周的妊娠绵羊在妊娠75天时接受全身麻醉（足月为145±5天）。在进行母体剖腹术和子宫切开术后，打开胎儿腹部。一旦识别出空肠回肠肠袢，分离、结扎并切断2只胎儿的肠系膜血管，其余5只胎儿的肠袢进行结扎。另外2只胎儿用作对照，仅接受剖腹术。在这7只胎儿中，2只在胎龄100 - 105天时再次手术并进行肠再通术。8只胎儿通过剖宫产足月分娩，其余1只自然分娩。1只新生儿接受了新生儿肠肠吻合术。
6只胎儿中有4只存活，宫内肠管或血管结扎引发了“肠闭锁样”表现。出生时接受手术的动物死亡。2只对照胎儿和2只接受宫内肠再通术的胎儿存活至足月。
本研究表明在实验模型中宫内治疗肠梗阻是可行的。
