这项工作得到了广东省消化疾病临床医学研究中心项目（2020B1111170004）、国家临床重点学科和广东省消化疾病临床医学研究中心项目资助。

该操作是常规操作，并已获得伦理批准。本研究经中山大学六附属医院伦理委员会批准。同时，取得了患者的知情书面同意。其研究内容和方法符合医学伦理规范和要求。
1. 患者选择
<ol><li>使用以下纳入标准：良性胰腺肿瘤，包括血管瘤、良性神经内分泌肿瘤、浆液性或粘液性囊腺瘤、实体假性状瘤和非侵入性导管内粘液瘤。</li>
	<li>使用以下排除标准：胰腺恶性肿瘤、胰腺体尾部萎缩、胰腺弥漫性炎症和血管变异。</li>
</ol>2.术前准备、手术体位、麻醉
<ol><li>要求患者在手术前 1 天摄入低脂肪、低盐和低糖的饮食，然后在手术前至少 8 小时禁食和饮水。</li>
	<li>将患者置于仰卧位，头部抬高并略微向左倾斜。手术是使用双初级刀模式进行的。 注意：在双主刀模式下，两名熟练且经验丰富的外科医生根据需要在外科医生和助手的角色之间交替，旨在提高效率和质量。</li>
	<li>进行气管插管并给予全身麻醉。根据患者麻醉后和术中情况判断麻醉效果，如麻醉完全阻滞、术中无额外药物、生命体征稳定等。</li>
</ol>3. 手术技术
<ol><li>在肚脐右侧上方 2 厘米处做一个垂直切口，并用 Veress 针建立气腹。插入一个 12 毫米套管针并在建立气腹后引入腹腔镜。</li>
	<li>在以下位置放置五个套管针：在脐上区域放置一个 12 毫米套管针进行观察，在右前腋窝线放置一个 5 毫米套管针，在右锁骨中线肋缘下方放置一个 12 毫米套管针，在剑突下方 2 厘米处水平放置一个 5 毫米套管针，在脐上水平水平 2 厘米处放置一个 12 毫米套管针（见 图 2）。</li>
	<li>仔细探查腹膜内器官和腹膜表面，发现胰腺上方有一个肿块，从胰腺表面突出，大小约为 3 厘米 x 3 厘米。</li>
	<li>使用超声刀分离腹粘连并切除一部分网膜组织。</li>
	<li>使用超声刀释放胃上皮动脉的较大曲率侧组织，使用夹子悬浮胃的较大曲率（见 材料表），并暴露胰腺。</li>
	<li>术中 B 超定位后，使用超声手术刀从胰腺肿块边缘靠近胰腺颈部的边缘切除 1 cm 的正常胰腺组织。</li>
	<li>使用超声刀释放胰腺后上部的脾动脉和静脉。然后，释放胰腺尾部和身体与脾管之间的结缔组织（见 图3）。</li>
	<li>使用超声手术刀完全切除胰腺肿块，并切除胰腺肿块边缘近端 1 cm 处的正常胰腺组织。</li>
	<li>将支架管放入胰管内胰腺的近端和远端侧（见 图4）。 注意：胰管中支架管的直径和长度分别为 2 mm 和 6 cm。（见 材料表）。</li>
	<li>使用4-0 priline连续缝合胰腺组织（见 图5;见 材料表），并在肚脐下方2cm处做一个延伸切口以去除胰腺肿块。</li>
	<li>用生理盐水冲洗腹腔以检查是否有任何出血点，并分别在胰腺吻合口的上方和下方放置引流管。最后，缝合切口（见 图2），手术结束。</li>
</ol>4. 术后护理与监测
<ol><li>术后进行心电图监测和低流量氧气检查。</li>
	<li>给予患者半流质饮食，并指导患者在手术后第1天在 床上翻身和运动。</li>
	<li>提供保肝、抗炎、止血、镇痛、白蛋白、抑酸治疗。</li>
	<li>术后第1天、第3天、第4天、第5天监测 引流管中的淀粉酶变化。</li>
</ol>

<ol>
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作者没有利益冲突或财务关系需要披露。

胰腺是人体重要的消化器官，具有几个重要的分泌功能。因此，在胰腺手术中，需要注意胰腺实质及其功能的保留。随着良性胰腺肿瘤和低级别恶性肿瘤检出率的提高，已经开发了各种手术来保护功能，包括胰腺局部摘除术、胰腺中段切除术和保留十二指肠的胰头切除术12,13。与以前的胰十二指肠切除术或胰腺体和胰尾相比，这些功能保留的胰腺手术旨...

从临床角度来看，需要注意的是，并非所有在胰腺中发展的肿瘤都被归类为胰腺癌。胰腺肿瘤大致可分为两大类：胰腺良性肿瘤和胰腺恶性肿瘤。胰腺良性肿瘤包括囊腺瘤、导管内状粘液性肿瘤、胰腺血管瘤等1.多年来，良性胰腺肿瘤的检出率一直在不断提高，手术仍然是最有效的治疗选择2。然而，传统的外科手术，如胰十二指肠切除术或胰腺体尾切除术，在确保完全切除肿瘤的同时，往往会导致过多的正常胰腺组织被切除。这会显着影响患者的长期生活质量，特别是导致内分泌和外分泌功能障碍的发生率增加 3,4。
近年来，由于腹腔镜手术和机器人手术等微创技术的快速发展，腹腔镜胰腺手术领域取得了长足的进步5。这导致进行腹腔镜胰腺手术的医院数量增加，并产生了积极的结果。在各种手术方法中，腹腔镜胰腺中段切除术被认为是治疗位于胰腺颈部或近端的良性或低级别恶性肿瘤的最合适方法6。
2003 年，Baca 团队对一名胰腺囊腺瘤7 号患者进行了首次胰腺中段切除术，从那时起，该手术已在世界范围内采用。与胰腺肿瘤局部摘除术、腹腔镜胰腺尾部切除术和腹腔镜胰十二指肠切除术等其他技术相比，胰腺中段切除术具有保留正常胰腺实质和降低胰腺内外分泌不足风险的优势 4,6,8.然而，切除胰腺的中间部分后会出现挑战，因为传统上，胰腺的断端被认为无法吻合。为了重建消化道，采用两种主要方法。第一种方法涉及单次吻合，即在闭合近端后，胰腺的远端与胃或空肠吻合。第二种方法是双吻合术，其中胰腺的近端和远端都与空肠吻合，呈Ω形状。然而，这些重建技术会给患者带来胰腺残端瘘和胰肠造口术瘘的风险，从而导致腹部感染和腹腔出血。克服这些挑战仍然是胰腺外科医生的一个重大问题 8,9。
本文提出了一种新的治疗方法，称为腹腔镜胰腺中部切除术结合端到端吻合术。该方法包括切除胰腺中部的肿瘤，并将支架管放入胰腺两端的胰管中。然后连续缝合胰腺组织以重建胰腺。该方法的主要目的是在切除肿瘤的同时保留胰腺的物质和功能，从而降低术后胰瘘、继发感染和出血的风险10,11。此外，它还旨在提高手术安全性。
病人为一名57岁男性，因在CT扫描中发现胰腺肿块而入院。肿块为圆形囊性结构，密度低，尺寸约为 28 mm x 40 mm，边界不明确。患者有II型糖尿病病史3年，乙型肝炎病毒感染史10年以上。术前测得甲胎蛋白（AFP）和癌胚抗原（CEA）水平分别为30.53 ng/mL和5.8 ng/mL。2022 年 6 月 15 日进行了腹腔镜胰中段切除术联合端对端吻合术。术后病理报告显示胰腺组织中存在一个实体囊性肿块，尺寸为 3.8 cm x 2.5 cm x 2 cm。肿块呈灰色和白色，囊肿含有透明液体，边界清晰（见 图1）。术后病理证实为胰腺血管瘤。术后肿瘤标志物和引流管淀粉酶水平呈下降趋势，患者恢复成功。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>abdominal instrument button</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>abdominal instrument cap</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>abdominal instrument collar</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>abdominal instrument connector</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Absorbable ligature clip</td>
			<td>Sichuan Guona Technology Co., LTD</td>
			<td>230716</td>
			<td></td>
		</tr>
		<tr>
			<td>barbs</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>blade</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>blood pad</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Cloth towel forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>disposable drainage tube</td>
			<td>Johnson &#38; Johnson</td>
			<td>412280</td>
			<td>6 cm x 2 mm</td>
		</tr>
		<tr>
			<td>Electric knife head</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>hilt</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>holding flask</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>intestinal forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>laparoscope</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>laparoscopic instruments</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Ligating clip</td>
			<td>Teleflex Medical</td>
			<td>73H2300118</td>
			<td></td>
		</tr>
		<tr>
			<td>long curved forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>medium curved forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Nail clamp</td>
			<td>Ethicon,USA&#160;</td>
			<td>584C82</td>
			<td></td>
		</tr>
		<tr>
			<td>needle holders</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>ovoid forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Paraffin oil</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>purse string forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>right angled forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>right angled forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>scissors</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Siphonhead</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Small cup</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>small curved forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sonotome keyhole</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>steel ruler</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Straight forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Suction needle plate</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Suture needle</td>
			<td>Johnson &#38; Johnson</td>
			<td>Vcp397H</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>syringe needle</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>tissue forceps</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>trocar(XCEL)</td>
			<td>Ethicon Endo-Surgery</td>
			<td>695C71</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasonic knife spacers</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>ultrasound knife</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>yarn ball</td>
			<td>Johnson &#38; Johnson</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

application of mid-pancreatectomy with end-to-end anastomosis in pancreatic benign tumors

胰腺中部切除术联合端对端吻合术是一种用于治疗良性胰腺肿瘤的外科手术。它涉及从胰腺的中部切除肿瘤，并通过吻合术连接近端和远端。切除胰腺中段的传统手术方法包括闭合近端胰腺并与空肠形成 Roux-en-Y 吻合口。然而，这种方法在术后存在胰腺残端瘘和胰腺肠吻合口瘘的双重风险。在本文中，描述了一种新的程序，在确保有足够的胰腺远端远端自由度后，将支架管放置在胰管的近端和远端侧。然后在直视下连续缝合胰实质，实现胰腺端对端吻合。该手术有助于保持胰腺功能，降低术后胰腺功能不全的风险。然而，由于涉及的复杂性和风险，手术前必须进行彻底的评估和准备。我们会仔细评估患者的病史、血清学检查和影像学检查结果，以确定手术的可行性和有效性。在手术过程中，我们会考虑使用合适的胰管支架，以确保胰液通过生理途径流入肠道。我们的目标是切除肿瘤，同时保留尽可能多的正常胰腺组织用于吻合术。术后，监测患者的胰腺功能至关重要，密切注意胰腺吻合口的血糖水平、引流液量和淀粉酶值。在术后随访期间，评估了患者的胰腺功能，与手术前相比，生活质量没有显着变化。这表明胰腺中段切除术联合端对端吻合术是治疗胰腺良性肿瘤的一种安全有效的手术。

手术在1.5 h内完成，术中最小出血量为50 mL，无需输血。术中脾动静脉的解离足以为保护胰尾和脾脏提供有效的保护。中央胰腺切除术后留下的间隙为 1.7 毫米。无短期并发症，患者术后恢复成功。住院时间为20天，术后住院时间为10天。引流淀粉酶水平从术后第1天的29300 U/L下降到术后第5天的58.39 U/L。从患者身上采集静脉血。血液中CEA水平从术前的5.8 ng/mL下降到术后的2.28 ng/mL。此外，AFP水平从术前...

Read this Scientific Article Protocol about Application of Mid-Pancreatectomy with End-to-End Anastomosis in Pancreatic Benign Tumors at JoVE.com

Application of Mid-Pancreatectomy with End-to-End Anastomosis in Pancreatic Benign Tumors

本方案描述了胰腺中段切除术联合端对端吻合术在胰腺良性肿瘤手术治疗中的应用，为管理此类肿瘤同时保留胰腺功能提供了一种可行的解决方案。

胰腺中段切除术联合端对端吻合术在胰腺良性肿瘤中的应用

Mid-pancreatectomy combined with end-to-end anastomosis is a surgical procedure used to treat benign pancreatic tumors. It involves removing the tumor ...

在麻醉患者身上做一个垂直切口后，仔细探索腹膜内器官和腹膜表面，露出胰腺上方约三厘米乘三厘米的肿块。使用超声刀分离腹部粘连并切除一部分网膜组织。在超声刀的帮助下，释放胃上皮动脉的较大曲率的侧组织。用夹子悬浮胃的大曲率，并暴露胰腺。术中B超定位后，用超声手术刀从胰腺肿块边缘靠近胰腺颈部处切除一厘米的正常胰腺组织。现在，在超声刀的帮助下释放胰腺上后部的脾动脉和静脉。然后，释放胰腺尾部和体部与脾管之间的结缔组织。使用超声手术刀完全切除胰腺肿块，以去除距胰腺肿块边缘近端 1 厘米处的正常胰腺组织。将支架管放入胰管内胰腺的近端和远端两侧。使用4-0 Prolene连续缝合胰腺组织，并在肚脐下方两厘米处做一个延伸切口以去除胰腺肿块。腹腔镜胰腺中段切除术联合端到端吻合术显示，引流淀粉酶水平从术后第一天的 29， 300 单位/升下降到术后第五天的 58.39 单位/升。静脉血分析显示，癌胚抗原水平从术前 5.8 纳克/毫升降低到术后 2.28 纳克/毫升。甲胎蛋白水平从手术前的 30.53 纳克/毫升下降到手术后的 7.66 纳克/毫升。

application-mid-pancreatectomy-with-end-to-end-anastomosis-pancreatic

Research

JoVE Journal

Medicine

249 次观看.  Sun Yat-sen University. 在麻醉患者身上做一个垂直切口后，仔细探索腹膜内器官和腹膜表面，露出胰腺上方约三厘米乘三厘米的肿块。使用超声刀分离腹部粘连并切除一部分网膜组织。在超声刀的帮助下，释放胃上皮动脉的较大曲率的侧组织。用夹子悬浮胃的大曲率，并暴露胰腺。术中B超定位后，用超声手术刀从胰腺肿块边缘靠近胰腺颈部处切除一厘米的正常胰腺组织。现在，在超声刀的帮...

视频: Application of Mid-Pancreatectomy with End-to-End Anastomosis in Pancreatic Benign Tumors

A Protocol for Genetic Induction and Visualization of Benign and Invasive Tumors in Cephalic Complexes of Drosophila melanogaster

Drosophila has illuminated our understanding of the genetic basis of normal development and disease for the past several decades and today it continues to contribute immensely to our understanding of complex diseases 1-7. Progression of tumors from a benign to a metastatic state is a complex event 8 and has been modeled in Drosophila to help us better understand the genetic basis of this disease 9. Here I present a simple protocol to genetically induce, observe and then analyze the progression of tumors in Drosophila larvae. The tumor induction technique is based on the MARCM system 10 and exploits the cooperation between an activated oncogene, RasV12 and loss of cell polarity genes (scribbled, discs large and lethal giant larvae) to generate invasive tumors 9. I demonstrate how these tumors can be visualized in the intact larvae and then how these can be dissected out for further analysis. The simplified protocol presented here should make it possible for this technique to be utilized by investigators interested in understanding the role of a gene in tumor invasion.

A Protocol for Genetic Induction and Visualization of Benign and Invasive Tumors in Cephalic Complexes of Drosophila melanogaster

Cooperation between an activated oncogene like RASV12 and mutations in cell polarity genes like scribbled, result in tumor growth in Drosophila where tumor cells also display invasive behaviors. Here a simple protocol for the induction and observation of the benign and invasive tumors is presented.

一个协议，用于基因诱导和良性和浸润性肿瘤可视化的头侧配合<em&gt;果蝇</em

Drosophila has illuminated our  understanding of the genetic basis of normal development and disease for the  past several decades and today it continues ...

科研

医学

Murine Ileocolic Bowel Resection with Primary Anastomosis

Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn&#8217;s disease and colon cancer being two common examples. Despite the frequency of these procedures, a significant knowledge gap remains in describing the inherent effects of intestinal resection on host physiology and disease pathophysiology. This article provides detailed instructions for an ileocolic resection with primary end-to-end anastomosis in mice, as well as essential aspects of peri-operative care to maximize post-operative success. When followed closely, this procedure yields a 95% long-term survival rate, no failure to thrive, and minimizes post-operative complications of bowel obstruction and anastomotic leak. The technical challenges of performing the procedure in mice are a barrier to its wide spread use in research. The skills described in this article can be acquired without previous surgical experience. Once mastered, the murine ileocolic resection procedure will provide a reproducible tool for studying the effects of intestinal resection in models of human disease.

Ileocolic resection is commonly performed in several human diseases; however, little is known regarding the impact of intestinal resection on surgical illnesses. This article provides instruction on executing the procedure in mice with high success, providing a means to study the effects of ileocolic resection in models of disease.

鼠回结肠肠管切除原发性吻合

Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn&#8217;s disease and colon cancer ...

Application of End-to-end Anastomosis in Robotic Central Pancreatectomy

Central pancreatectomy is carried out for the treatment of benign or low-malignant potential tumors located in the pancreatic neck or proximal part of pancreatic body. With technological development, the robotic surgical system has shown its advantage in minimally invasive surgery and been increasingly applied in central pancreatectomy. However, reconstruction of the continuity of pancreas with end-to-end anastomosis after robotic central pancreatectomy has not been applied. In this study, we report surgical techniques for robotic central pancreatectomy with end-to-end anastomosis. The pancreas is reconstructed by duct-to-duct anastomosis of the pancreatic duct with a pancreatic stent inserted in the two stumps of pancreatic duct, and by end-to-end anastomosis of the pancreatic parenchyma. Compared with traditional central pancreatectomy with pancreaticoenteric anastomosis, this approach decreases the operative injury to the patient, and also conserves the integrity and continuity of the digestive duct and pancreatic duct. The robotic surgical system integrated with multiple instruments with flexible and precise movement is particularly suitable for the dissection and reconstruction of the pancreatic duct. We found that robotic central pancreatectomy with end-to-end anastomosis is safe and feasible, and we need more experience to evaluate its best indications and long-term outcomes.

The robotic central pancreatectomy with end-to-end anastomosis is feasible and safe for tumor in the pancreatic neck and proximal portion of pancreatic body. The operative techniques of this operation are presented.

端到端吻合技术在机器人中心胰腺中的应用

Central pancreatectomy is carried out for the treatment of benign or low-malignant potential tumors located in the pancreatic neck or proximal part of ...

Creation of Colonic Anastomosis in Mice

Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of colonic surgeries and can occur in up to 26% of surgical anastomoses, with mortality being up to 39% for patients with such a leak. Currently, there remains a paucity of data detailing the cellular mechanisms of anastomotic healing. Devising preventative strategies and treatment modalities for anastomotic leak could be greatly potentiated by a better understanding of appropriate anastomotic healing.
A murine model is ideal as previous studies have shown that the murine anastomosis is the most clinically similar to the human case as compared with other animal models. We offer an easily reproducible murine model of colonic anastomosis in mice that will allow for further illustration of anastomotic healing.

Anastomotic leak or breakdown after surgery is a major cause of postoperative morbidity and mortality. Our surgery for creating a colonic anastomosis is a reliable and reproducible method for studying the healing mechanisms of anastomoses.

小鼠结肠吻合术的建立

Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of ...

One-anastomosis Gastric Bypass (OAGB) in Rats

The goal of this protocol is to set up a preclinical model of bariatric surgery and, more specifically, OAGB in obese rats. Based on this preclinical model, longitudinal studies can be carried out to provide an improved understanding of the mechanisms underlying the outcomes seen after bariatric surgery in humans. For this purpose, rats are operated on through a laparotomy under general anesthesia with isoflurane. First, the surgeon creates a long and tubular gastric pouch: after greater curve and hiatal dissection, the nonglandular stomach is stapled and removed. Then, the remaining stomach is also stapled in order to create a gastric tube and exclude the antrum of the stomach. After that, the surgeon performs a single end-to-side gastrojejunostomy 35 cm from the duodenojejunal angle. This limb length has been chosen in order to reproduce the same ratio between the biliopancreatic limb (BPL) and common limb (CL) length as in human bariatric surgery. The operation ends by aponeurotic and cutaneous closure. The early postoperative management consists of subcutaneous hydration, an intramuscular prophylactic antibiotic injection, a parietal injection of xylocaine, the administration of painkillers, and a progressive reintroduction of diet.

One-anastomosis Gastric Bypass OAGB in Rats

This protocol is for the performance of one-anastomosis gastric bypass (OAGB) on rat. The operator performs a long and tubular-stapled gastric pouch followed by hand-sewn anastomosis. For this model, the operator reproduces the same ratio between biliopancreatic and common limb in humans; therefore, the biliopancreatic limb measures 35 cm.

大鼠胃旁路 (oagb) 的一次吻合

The goal of this protocol is to set up a preclinical model of bariatric surgery and, more specifically, OAGB in obese rats. Based on this preclinical ...

A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application

Cardiovascular disease remains the leading cause of death and disability worldwide, in part due to atherosclerosis. Atherosclerotic plaque narrows the luminal surface area in arteries thereby reducing adequate blood flow to organs and distal tissues. Clinically, revascularization procedures such as balloon angioplasty with or without stent placement aim to restore blood flow. Although these procedures reestablish blood flow by reducing plaque burden, they damage the vessel wall, which initiates the arterial healing response. The prolonged healing response causes arterial restenosis, or re-narrowing, ultimately limiting the long-term success of these revascularization procedures. Therefore, preclinical animal models are integral for analyzing the pathophysiological mechanisms driving restenosis, and provide the opportunity to test novel therapeutic strategies. Murine models are cheaper and easier to operate on than large animal models. Balloon or wire injury are the two commonly accepted injury modalities used in murine models. Balloon injury models in particular mimic the clinical angioplasty procedure and cause adequate damage to the artery for the development of restenosis. Herein we describe the surgical details for performing and histologically analyzing the modified, pressure-controlled rat carotid artery balloon injury model. Additionally, this protocol highlights how local periadventitial application of therapeutics can be used to inhibit neointimal hyperplasia. Lastly, we present light sheet fluorescence microscopy as a novel approach for imaging and visualizing the arterial injury in three-dimensions.

The rat carotid artery balloon injury mimics the clinical angioplasty procedure performed to restore blood flow in atherosclerotic vessels. This model induces the arterial injury response by distending the arterial wall, and denuding the intimal layer of endothelial cells, ultimately causing remodeling and an intimal hyperplastic response.

大鼠胡萝卜动脉压力控制段气球损伤与腹腔ventit 治疗应用

Cardiovascular disease remains the leading cause of death and disability worldwide, in part due to atherosclerosis. Atherosclerotic plaque narrows the ...

On-Site Sampling and Extraction of Brain Tumors for Metabolomics and Lipidomics Analysis

Despite the variety of tools available for cancer diagnosis and classification, methods that enable fast and simple characterization of tumors are still in need. In recent years, mass spectrometry has become a method of choice for untargeted profiling of discriminatory compound as potential biomarkers of a disease. Biofluids are generally considered as preferable matrices given their accessibility and easier sample processing while direct tissue profiling provides more selective information about a given cancer. Preparation of tissues for the analysis via traditional methods is much more complex and time-consuming, and, therefore, not suitable for fast on-site analysis. The current work presents a protocol combining sample preparation and extraction of small molecules on-site, immediately after tumor resection. The sampling device, which is of the size of an acupuncture needle, can be inserted directly into the tissue and then transported to the nearby laboratory for instrumental analysis. The results of metabolomics and lipidomics analyses demonstrate the capability of the approach for the establishment of phenotypes of tumors related to the histological origin of the tumor, malignancy, and genetic mutations, as well as for the selection of discriminating compounds or potential biomarkers. The non-destructive nature of the technique permits subsequent performance of routinely used tests e.g., histological tests, on the same samples used for SPME analysis, thus enabling attainment of more comprehensive information to support personalized diagnostics.

The manuscript presents on-site sampling of human brain tumors with solid phase microextraction followed by their biochemical profiling towards the discovery of biomarkers.

代谢组学和利皮多米分析脑肿瘤的现场采样与提取

Despite the variety of tools available for cancer diagnosis and classification, methods that enable fast and simple characterization of tumors are still ...

Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Model in Mice

Obesity is a major health issue worldwide. As a response, bariatric surgeries have emerged to treat obesity and its related comorbidities (e.g., diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, cardiovascular events, and cancers) through restrictive and malabsorptive mechanisms. Understanding the mechanisms by which these procedures allow such improvements often require their transposition into animals, especially in mice, because of the ease of generating genetically modified animals. Recently, the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a procedure that uses both restrictive and malabsorptive effects, which is being used as an alternative to gastric bypass in case of major obesity. Thus far, this procedure has been associated with strong metabolic improvements, which has led to a marked increase in its use in daily clinical practice. However, the mechanisms underlying these metabolic effects have been poorly studied as a result of a lack of animal models. In this article, we present a reliable and reproducible model of SADI-S in mice, with a special focus on perioperative management. The description and use of this new rodent model will be helpful for the scientific community to better understand the molecular, metabolic, and structural changes induced by the SADI-S and to better define the surgical indications for clinical practice.

Single-anastomosis duodeno-ileal bypass (SADI-S) is an emerging bariatric procedure with important metabolic effects. In this article, we present a reliable and reproducible model of SADI-S in mice.

小鼠单吻合十二指肠回肠旁路与袖状胃切除术模型

Obesity is a major health issue worldwide. As a response, bariatric surgeries have emerged to treat obesity and its related comorbidities (e.g., diabetes ...

Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to be maintained during laparoscopic hepatectomy, with a residual liver volume of &gt;40% in cirrhotic patients and &gt;30% in non-cirrhotic patients. The high incidence of complications such as bleeding, bile leakage, or liver failure due to the exposure and difficulty of the resection of specific liver segments such as S2 and S7 reduces the success rate of liver resection. At present, microwave ablation is mainly applied in the treatment of liver metastasis using a percutaneous approach, which makes it difficult to identify hidden parts or small lesions. For some liver segments, the percutaneous puncture of liver segment 7 (S7) is likely to pass through the thoracic cavity, and the percutaneous puncture of liver segment 2 (S2) adjacent to the diaphragm is likely to injure the diaphragm and heart; these issues restrict the application of percutaneous ablation in colorectal cancer liver metastasis. Considering multiple lesions, laparoscopic microwave ablation combined with hepatectomy was performed in this study. The location of the lesions was determined by contrast-enhanced ultrasound under laparoscopy, and small lesions that were difficult to detect before the operation were identified. For the scattered lesions, which had diameters less than 3 cm and were difficult to resect, ablation was adopted to substitute hepatectomy. This technique helped to more explicitly locate the tumors, simplified the operation procedures, reduced the risk of complications such as bleeding and bile leakage, shortened the operation time, accelerated the postoperative recovery, significantly improved the success rate of operation, and enhanced the clinical prognosis of colorectal cancer liver metastasis by surgical resection.

This protocol describes the laparoscopic resection of colorectal cancer liver metastases combined with ultrasound-guided microwave ablation. This technique can safely, effectively, and accurately treat refractory liver metastases &lt;3 cm, reduce postoperative complications, and accelerate the postoperative rehabilitation of patients.

腹腔镜肝切除术联合术中微波消融术在结直肠癌肝转移中的应用

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to ...

使用改进的 Videman 方法在兔子中建立 KOA 模型

Application of Acupotomy in a Knee Osteoarthritis Model in Rabbit

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of people with KOA. Among several pathogenic factors, the biomechanical imbalance of the knee joint is one of the main causes of KOA. Acupotomology believes that restoring the mechanical balance of the knee joint is the key to treating KOA. Clinical studies have shown that acupotomy can effectively reduce pain and improve knee mobility by reducing adhesion, contracture of soft tissues, and stress concentration points in muscles and tendons around the knee joint. 
In this protocol, we used the modified Videman method to establish a KOA model by immobilizing the left hindlimb in a straight position. We have outlined the method of operation and the precautions related to acupotomy in detail and evaluated the efficacy of acupotomy in conjunction with the theory of "Modulating Muscles and Tendons to Treat Bone Disorders" through the detection of the mechanical properties of quadriceps femoris and tendon, as well as cartilage mechanics and morphology. The results show that acupotomy has a protective effect on cartilage by adjusting the mechanical properties of the soft tissues around the knee joint, improving the cartilage stress environment, and delaying cartilage degeneration.

作者聚焦：研究针尖切开术治疗膝骨关节炎的作用机制

In this protocol, a knee osteoarthritis model was prepared using the modified Videman method, and the operation procedures and precautions of acupotomy are detailed. The effectiveness of acupotomy has been demonstrated by testing the mechanical properties of quadriceps femoris and tendon and the mechanical and morphological properties of cartilage.

针灸术在兔膝骨关节炎模型中的应用

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of ...