Objective To establish a simple, valid rat orthotopic left lung transplantation model with the improved operation technique. Methods One hundred and thirty-six male SD rats were randomly divided into donor （n = 68） and recipient （n = 68）, transplantation were performed by using the improved cuff anastomosis technique. Results Time of donor lung perfusion-picking, donor lung vessel cuff anastomosis and recipient vessel anastomosis was 13±2 min, 9±1 min, 10±1 min respectively, the operative time was 60±3 min. In 68 rats of operations, successful rate was 88%（60/68）, anastomotic stoma leak in one rat, lung congestion 3 rats, lung atelectasis 4 rats. The shortest survival time was 1 day, there were 53 rats whose survival time was longer than 12 days. The chest computed tomography showed no atelectasis and blood gas analysis manifested good respiratory function. Conclusion The improved three cuff anastomosis technique offers a simple, valid, cheap and useful method,it can establish rat orthotopic left lung transplantation model successfully.
Objective To analyze the effects of different perfusion and different superior hepatic vena cava anastomosis methods on the establishment of rat orthotopic liver transplantation model. Methods Eighty SD rats were randomly grouped with donor group and recipient group with 40 rats in each group. Ten rats in the donor liver acquisition group received abdominal aorta infusion set drip irrigation (1 drop/s); 10 rats received abdominal aorta micro-pump perfusion method (6 mL/min); and then received recipient liver transplantation (corresponding to 10 rats in each group). The donor liver perfusion time and donor liver acquisition time of rats in the 2 groups were collected. HE staining was performed on liver tissues after perfusion and 24 h after liver transplantation. Ten rats in the recipient liver transplantation group received continuous anastomosis, and 10 rats received tension-reducing half-needle anastomosis. We collected the anastomosis time of superior and inferior hepatic vena cava, the time of anhepatic stage and the incidence of postoperative complications of the recipient. Results Contrasted with abdominal aorta infusion group, the perfusion time and acquisition time of donor liver were shorter in the abdominal aorta micro-pump perfusion group (P＜0.05). HE staining showed that the morphology of hepatocytes, portal vein and bile duct in the abdominal aorta micro-pump perfusion group did not change obviously, only a few lymphocytes infiltrated. Contrasted with continuous anastomosis group, the anastomosis time, anhepatic stage of the superior hepatic vena cava, incidences of postoperative anastomotic bleeding and incomplete perfusion of donor liver in the reduced tension half-needle anastomosis group were shorter or lower (P＜0.05). Conclusions Compared with abdominal aorta infusion set drip method, the quality of donor liver was improved by abdominal aorta micropump perfusion. Compared with continuous anastomosis method, the tension-reducing half-needle anastomosis can shorten the suture time of superior hepatic vena cava and anhepatic stage, and the incidence of anastomotic bleeding was reduced.
Objective To explore the strategy of intrathoracic anastomosis in patients with esophageal squamous cell carcinoma when the proximal esophagus is dilated to different degrees and explore its mechanism. Methods We retrospectively reviewed the clinical data of patients who underwent esophagectomy between 2014 and 2017 in West China Hospital. The patients were divided into two groups including a significant dilatation group with inner mucosal phase diameter (IMPD)≥17.9 mm and a non-significant dilatation group with IMPD<17.9 mm. And the patients were divided into two groups (a layered manual anastomosis group and a stapled anastomosis group) according to anastomosis method and propensity score matching was applied to adjust for potential confounders. Results We finally included 654 patients. There were 206 patients with 158 males and 48 females at average age of 62.21±7.72 years in the layerd manual analstomosis group and 448 patietns with 377 males and 71 females at average age of 62.57±8.42 years in the stapled anastomosis group. We also used Masson trichrome staining to assess the collagen fiber content in the esophagus. Compared with layered manual anastomosis, the incidence of anastomotic leakage was higher in the significant dilatation group than that in the stapled anastomosis group (original cohort: 3.8% vs. 10.7%, P=0.093; propensity score-matched cohort: 1.4% vs. 15.3%, P=0.004). And there was no significant difference in anastomotic leakage b etween layered manual anastomosis and stapled anastomosis in the non-significant dilatation group (original cohort: 4.7% vs. 4.2%, P=0.830; propensity score-matched cohort: 4.8% vs. 4.0%, P=0.206). Moreover, the average collagen fiber area ratio was significantly lower in the significant dilation group than that in the non-significant dilatation group (P=0.045). Conclusion There is a significant reduction in collagen fibers in the proximal esophageal wall tissue of esophageal squamous cell carcinoma patients with a IMPD≥17.9 mm. Intrathoracic layered manual anastomosis effectively reduces postoperative anastomotic leakage in these patients.