【摘要】 目的:探讨成年比格犬作为同种异体阴茎移植动物模型可行性,进一步探讨稳定的阴茎移植动物模型建立条件。方法:按照实验动物模型建立原则,进行移植阴茎相似性、重复性、可行性、适用性和可控性研究。20只成年比格犬阴茎与10例成人阴茎解剖学要点比较,分析主要存在的共同特点和相似性;10对成年比格犬阴茎在显微外科技术辅助下进行交叉移植,并采用FK506+MMF+MP免疫抑制方案,观察移植阴茎存活情况;10只显微外科技术辅助比格犬阴茎离断再植术相关指标进行可操作性比较。结果:20只成年比格犬阴茎解剖学观察与10例成人阴茎解剖学观察具有高度相似性,相互比较统计学上无明显差异。10对成年比格犬阴茎交叉移植手术均获得成功,术后8只出现移植阴茎坏死,12只移植阴茎成功存活,恢复排尿功能;显微外科技术辅助下一次性静脉吻合成功率达95.0%(38/40),一次性动脉吻合成功率达87.5%(35/40),血管吻合时间(71.0±9.0)min,手术时间(133.0±10.3)min,失血量(135.8±41.4)ml。比较10只显微外科技术辅助下比格犬阴茎离断再植手术,一次性静脉吻合成功率达100%(20/20),一次性动脉吻合成功率达90.0%(18/20),血管吻合时间(65.0±7.9)min,手术时间(117.4±10.0)min,失血量(85.0±10.8)ml。12例临床显微外科技术辅助下成人阴茎离断再植手术,一次性静脉吻合成功率达100%(24/24),一次性动脉吻合成功率达95.8%(23/24),血管吻合时间(79.0±17.6)min,手术时间(125.0±20.6)min,失血量(140.0±44.3)ml。3组资料经统计学分析显示各项指标无显著性差异。结论:比格犬阴茎海绵体结构与人阴茎海绵体结构具有高度相似性,在阴茎海绵体横断面解剖中其主要解剖结构均相同;显微外科技术辅助下行比格犬阴茎再植和同种异体移植手术均获得了成功,其手术操作过程中各项指标与临床中人阴茎再植手术相比较,具有相近的可操作性、重复性和较强的可行性。因此,采用成年比格犬作为实验动物建立阴茎移植手术模型切实可行。更多还原

【Abstract】 Objective:To investigate the feasibility of establishing a model of allograft penile transplantation in adult beagle dogs and explore the conditions for constructing a stable animal model of penis transplant.Methods:Following the principles of similarity,repeatability,feasibility,applicability,and controllability in the construction of experimental animal models,we compared the major anatomic features of the penis of 20 adult beagle dogs with those of 10 adult men.Using microsurgical techniques,we performed cross-transplantation of the penis in the 20(10 pairs) beagle dogs and observed the survival rate of the transplanted penises by FK506+ MMF + MP immune induction.We compared the relevant indexes with those of the 10 cases of microsurgical replantation of the amputated penis.Results:High similarities but no statistically significant differences were observed in penile anatomic features between the 20 beagle dogs and 10 men.All the 10 cases of cross-transplantation of the penis were successfully completed in the 20 beagle dogs,of which the transplanted glans survived with normal micturition in 12 but developed necrosis in the other 8;the success rate of one-time venous anastomosis was 95.0%(38/40) and that of one-time arterial anastomosis was 87.5%(35/40),with an average vascular anastomosis time of(71.0 ± 9.0) minutes,a mean operation time of(133.0 ± 10.3) minutes,and a mean blood loss of(135.8 ± 41.4) ml.In the 10 cases of penile replantation,the success rate of one-time venous anastomosis was 100%(20/20) and that of one-time arterial anastomosis was 90.0%(18/20),with an average vascular anastomosis time of(65.0 ± 7.9) minutes,a mean operation time of(117.4 ± 10.0) minutes,and a mean blood loss of(85.0 ± 10.8) ml.In the 12 cases of replantation of the amputated penis,the success rate of one-time venous anastomosis was 100%(24/24) and that of one-time arterial anastomosis was95.8%(23/24),with an average vascular anastomosis time of(79.0 ± 17.6) minutes,a mean operation time of(125.0 ± 20.6)minutes,and a mean blood loss of(140.0 ± 44.3) ml.No statistically significant differences were found in the relevant indexes among the three groups.Conclusion:The anatomic structure of the corpus cavernosum penis of beagle dogs is highly similar to that of men,almost the same in cross-section anatomy.Microsurgical replantation and allograft transplantation of the penis were both successfully performed in beagle dogs,which showed similar operative indexes to those of human penile replantation.The construction of the allograft penile transplantation model in adult beagle dogs is feasible clinically,with the advantages of operability and repeatability.更多还原