The Comparative Study Between Laparoscopic Partial Nephrectomy And Open Partial Nephrectomy In Miniature Pigs

Laparoscopic surgery is a minimally invasive technology benefited on small trauma, visualization, less painful reaction, and quick recovery, etc. This technology was first started in the western countries at the beginning of 20 th century. As for China, its use was much later than western countries, while it promoted quickly. Now, it has showed the advantages in the field of medicine. With the development of veterinary surgical technique, the laparoscopic approache has been a discussed and colored topic in our country. One of the functions of this technique is to use for kidney neoplasm. In this paper, the laparoscopic surgery of partial nephrectomy was designed and organized, then its advantages and disadvantages were compared to evaluate the safety, practicability and feasibility in building miniature pig experimental models.In the tests, 10 female miniature pigs were randomly divided into two groups, marked as the laparoscopic partial nephrectomy group(LPN) and the open partial nephrectomy(OPN) group respectively. Especially, the surgical procedures of LPN were performed under the 10 mmHg pressure and the 2/3 part of kidney were resected with “three portals method”. During the operations, clinical signs, each physical signs of the respiratory and circulatory system were monitored. Venous blood and urine were collected from LPN and OPN seperately at preoperative, postoperative immediately, postoperative 1d, 2d, 3d, 5d, 7d, 14 d. Detected the routine blood, routine urine, IL-6, COR, GSH-PX, KIM-1, β2-MG and so on.All operations were completed successfully, the average time for each surgery was 80 min(63-90) for the OPN and 110 min(97-132) for the LPN, while the average incisions were 8cm(6-9) and 4.6cm(4-5) for the OPN and LPN respectively. Secondly, during the operations, the heart rate and blood pressure of LPN were higher than OPN. After the operation s, The LPN pigs had the lighter painful and a lower level of WBC IL-6 and COR than those for the OPN ones(P<0.01). As for the higher levels of SOD, GSH-PX, MDA, AST, ALT, Cre, BUN, KIM-1, Cys-C, β2-MG were happened on the OPN(P<0.01). Finally, the abdominal cavity adhesion of LPN is better than OPN.Based on the experimental results, it is clear to observe followed conclusions:(1) The partial nephrectomy model can be built successfully for miniature pigs by using laparoscopic minimally invasive surgery technology.(2) The monitoring date of the perioperative vital signs, circulation system, respiratory system, liver and kidney function, etc were maintained at a safe range, which demonstrated that the technology and operation method is safe and feasible.(3) Laparoscopic surgery and traditional laparotomy surgery have different features, the first one has small incision, light postoperative adhesion, small stress response and mini invasiveness. The second one has short option time and small kidney injury. We must combine the purpose and condition of experiment to determine surgery procedure.