| Objective: To study the de-epithelialization effect of different concentrations of AgNO3 solutions at different time points on intestines of rabbits and explore its clinical significance on enterocystoplasy.Methods: Forty rabbits were randomly divided into four groups (10 rabbits in each group). For each rabbit, one 15 cm segment of jejunum was isolated with intact mesentety. Intestinal anastomosis was performed to keep its continuity. The segments in group B were treated with 2g/100ml silver nitrate (AgNO3) solution for 30 minutes, while the segments in group C were treated with 5g/100ml AgNO3 solution for 10 minutes,and the mucosa of the segments in group D were stripped by surgical blade. The The segments in Group A were only treated with nomal Saline. Volume of free intestine was measured when the inner pressure was 14cmH2O(The pressure is the average pressure in normal rabbits bladder at the moment of miction. And the volume of free intestine at this pressure could reflect indirectly the compliance of the intestinal wall of the substitute bladder.). Thirty-three rabbits survived and were killed 8 weeks after operation, Volume of free intestines were measured too, and those free intestines were produced to sections stained with HE, PAS and masson's trichrome for histopathological analysis by light microscope.Results: At the end of the 8th week, it was displayed by HE stain that the intestinal mucosa layer in the samples of group A was integrated. In the samples of group B, there was defect in some parts of the intestinal mucosa layer and muscularis mucosa layer, and there weren't any muscularis mucosa below some parts of regeneration mucosa. In the samples of group C, there was a totally depletion of mucosa and there was a layer of false membrane constituted of cellulose, inflammatory cells and necrosis tissues over the intestinal wall. In the samples of group D, there was no mucosa layer and the submucosa layer was substituted by scar tissues. It was showed in PAS stain that there were all positive stains in group A, part of positive stains in group B and completely negative stains in group C and D. It was showed in masson's trichrome stain that there was no significant thickening of the collagen fiber in the submucosa layer in group A, B and C, and apparently thickening in group D. Comparing with group A, the collagen fiber despot index in group B and group C had no significant change after the operation (P>0.05). But there was significant change in group D (P<0.01). And in groups A, B and C, there were no significant difference between the volumes of freeintestines during the operation and those at the 8th week after the operation (P>0.05). But in group D there were significant difference between the intestinal volumes during the operation and those at the 8th week after the operation (P<0.01).Conclusion: AgNO3 solution can effectively inactivate intestinal mucous. Ten minutes' treatment of 5% AgNO3 solution can successfully de-epithclialize jijunal segments without creating severe retraction or fibrosis. This novel treatment can be very useful for enterocystoplasy. |
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