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Optimizing ischemic preconditioning for esophagogastric anastomosis: A standardized rat model to evaluate histological changes

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Authors: I. Kovac 1;  Z. Hribíková 2;  M. Miklosova 1;  K. Kovacova 2;  J. Gajdos 2;  D. Matiova 3;  D. Petrasova 3;  J. Belák 1
Authors‘ workplace: Department of Pathology, Louis Pasteur University Hospital and Pavol Jozef Safarik University, Kosice, Slovak Republic 2;  Laboratory of Research Bio-models, Pavol Jozef Safarik University, Kosice, Slovak Republic 3;  nd Department of Surgery, Louis Pasteur University Hospital and Pavol Jozef Safarik University, Kosice, Slovak Republic 12
Published in: Rozhl. Chir., 2024, roč. 103, č. 3, s. 84-90.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2024.103.3.84–90

Overview

Introduction: Na experimentálnu verifikáciu vitality žalúdočného tubulu pred ezofagektómiou je nevyhnutná existencia jednoduchého modelu. Ischémia je hlavná príčina dehiscencie ezofagogastrickej anastomózy a následného leaku anastomózy. Ischemická príprava žalúdočného tubulu pred ezofagektómiou je potencionálna možnosť ako zamedziť rozvoju nežiaducich komplikácií. Avšak technika ako aj optimálne načasovanie ischemizácie ostávajú nejasné.

Metody: Samce potkanov plemena Sprague-Dawley (n=24) boli náhodne rozdelené do štyroch skupín: ischemická skupina s odberom vzoriek po 1 hodine od ischémie (I1H), ischemická skupina s odberom vzoriek 1 deň od ischémie (I1D), ischemická skupina s odberom vzoriek 7 dní od ischémie (I7D) a kontrolná skupina (C). Ischémia bola navodená ligáciou a. gastrica sinistra a aa. gastricae breves. Vzorky boli histologicky a makroskopicky verifikované a stanovený bol počet a percentuálne zastúpenie jednotlivých imunokompetentných buniek.

Výsledky: V skupine I1H bola pozorovaná ischemická denudácia s mukozálnymi eróziami a celkový počet eozinofilov bol signifikantne vyšší (p<0.05) v tejto skupine v porovnaní so skupinami I1D a I7D. V skupine I1D bola pozorovaná redukcia zápalu a parciálna regenerácia žalúdočnej mukózy. V skupine I7D bola pozorovaná takmer kompletná architektonická regenerácia žalúdočného epitelu a počet polymorfonukleárov bol signifikantne nižší (p<0,05) ako v skupine I1D.

Záver: Ischemické poškodenie ligáciou žalúdočných tepien bolo predominantne pozorované v skupinách I1H a I1D avšak nie v skupine I7D. Táto práca prezentuje jednoduchú metódu verifikácie ischemických zmien žalúdočného tubulu.

Klíčová slova:

potkan – žalúdok – Ischemia – ezofagogastrická anastomóza – histologické zmeny

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doc. MUDr. Ivan Kováč, PhD.
2nd Department of Surgery,
Louise Pasteur University Hospital and P. J. Šafárik University
Rastislavova 43, 04011 Košice, Slovak Republic
e-mail: ivankovac.kovi@gmail.com
ORCID: 0000-0001-6717-5818

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