磁压榨技术治疗输尿管远端梗阻的实验研究

目的　探讨磁压榨吻合技术治疗输尿管远端梗阻的可行性。 方法　健康新西兰兔6只，以丝线结扎右侧输尿管远端，制作输尿管远端梗阻模型。4周后开腹确认输尿管扩张至5 mm以上为模型制备成功。在输尿管上段纵向切开输尿管长约5 mm，经此切口用软质导管缓慢推送子磁体至输尿管远端。在膀胱体部行荷包缝合后打开膀胱，切口长约5 mm，将母磁体置入膀胱，推送母磁体向子磁体靠近，子母磁体自动对位吸合挤压输尿管壁和膀胱壁。术后X线监测子母磁体脱落入膀胱，输尿管膀胱吻合即建立。磁体置入术后1月开腹获取标本，肉眼观察吻合口情况。 结果　所有实验动物顺利实施手术，术后存活状态良好。磁吻合术后9~16 d子母磁体脱落入膀胱。标本肉眼观察可见吻合口通畅，黏膜愈合良好。 结论　磁压榨技术安全可靠，可用于临床治疗肾移植术后输尿管远端梗阻。

Experimental study on the treatment of distal ureteral obstruction by magnetic compression technique

Objective　To explore the feasibility of using magnetic compression technique to treat distal ureteral obstruction.　Methods　Six New Zealand rabbits were ligated to the distal ureter of the right ureter with silk thread to simulate the model of distal ureteral obstruction after kidney transplantation. After 4 weeks, the ureteral dilatation was observed by laparotomy. It was confirmed that the model was successfully prepared when the ureter dilatation was 5 mm or more. The ureter was cut longitudinally about 5 mm in the upper ureter, where the daughter magnet was placed, and the daughter magnet was slowly pushed to the distal end of the ureter with a soft catheter. Another side, the body of bladder was opened and the incision was stitched by purse-string suture. The incision was about 5 mm long. The parent magnet was placed through the bladder incision, and the parent magnet was pushed to approach the daughter magnet. The parent and daughter magnets could be automatically aligned to absorb and compress the ureter and bladder wall. After a period time of operation, the daughter and parent magnets were detached into the bladder, and the ureter-bladder anastomosis was established. Specimens were obtained and the gross specimens of the anastomosis were observed with naked eyes.　Results　All the experimental animals were successfully operated and survived well after surgery. After 9-16 days, the daughter and parent magnets were detached into the bladder, and the ureter-bladder anastomosis was established. Obtaining anastomotic specimen showed that the anastomosis healed well.　Conclusions　Magnetic compression technique (MCT) is safe and feasible for the treatment of distal ureteral obstruction, which can be used clinically to treat distal ureteral obstruction after kidney transplantation.