Yorkshire幼猪腹腔镜回肠转位手术 模型的建立方法与体会

The method and experience about the surgery of laparoscopic ileal transposition in yorkshire swine

摘要:

目的 评价腹腔镜回肠转位手术对Yorkshire幼猪血糖代谢的调节作用并讨论模型建立的方法与体会。 方法 10只Yorkshire幼猪均实施腹腔镜回肠转位手术，在术前及术后2周行经十二指肠葡萄糖耐量试验，检测连续时间点动物血糖水平绘制成曲线，实验数据采用t检验，并观察手术时间、手术中转率、术后死亡率、伤口感染率、肠瘘发生率以及切口疝发生率等。 结果 所有幼猪均顺利完成腹腔镜回肠转位术，平均手术时间（107.4±21.5） min，无1例中转开腹，无1例死亡，无伤口感染、肠瘘及切口疝的发生，且术后第2周平均血糖峰值（12.15±2.61） mmol/L较术前（16.05±2.46） mmol/L（t=2.31，P <0.05）和Sham组（13.33±3.67）mmol/L（t=3.0774，P <0.01）显著降低，术后平均峰值时间（113.75±30.21） min较术前（65.00±32.07） min明显延迟（t=3.1297，P <0.01）。 结论 在Yorkshire猪大型哺乳类动物模型中，腹腔镜下回肠转位手术能有效调节血糖代谢，无明显严重并发症发生，是一种安全可行的代谢外科手术方式。

Abstract:

【Objective】 To evaluate the effect of laparoscopic ileal transposition operation on glycemia regulation in Yorkshire swine models, and to explore the method and experience of the surgery. 【Methods】 The Duodenum Glucose Tolerance Tests were performed in 10 Yorkshire swine all accepted laparoscopic ileal transposition. Within pre-operation and two weeks of pre-operation, consecutive blood samples were collected for glucose measurement and comparison. Besides, operation duration, mortality, incidence of conversion to laparotomy, wound infection, intestinal fistula and incisional hernia were observed. 【Results】 Laparoscopic ileal transposition was completed successfully on all swine; There was none of wound infection, intestinal fistula and incisional hernia. In two weeks post-operation, the peak value of glycemia (12.15±2.61) mmol/L was significant lower than that in pre-operation (16.05±2.46) mmol/L (t =3.0774, P ＜0.01), and the glycemic peak-time was significantly delayed in two weeks post-operation (113.75±30.21) min when compared with pre-operation (65.00±32.07) min (t =3.1297, P ＜0.01). 【Conclusion】 Due to improvement of the glycemia metabolism and without complications, laparoscopic ileal transposition is a safe and feasible metabolic surgery in large mammals.