title: The development of a canine anorectal autotransplantation model based on blood supply: a preliminary case report.
abstract: Colostomy is conventionally the only treatment for anal dysfunction. Recently, a few trials of anorectal transplantation in animals have been published; however, further development of this technique is required. Moreover, it is crucial to perform this research in dogs, which resemble humans in anorectal anatomy and biology. We designed a canine anorectal transplantation model, wherein anorectal autotransplantation was performed by anastomoses of the rectum, inferior mesenteric artery (IMA) and vein, and pudendal nerves. Resting pressure in the anal canal and anal canal pressure fluctuation were measured before and after surgery. Graft pathology was examined three days after surgery. The anal blood supply was compared with that in three beagles using indocyanine green (ICG) fluorescence angiography. The anorectal graft had sufficient arterial blood supply from the IMA; however, the graft's distal end was congested and necrotized. Functional examination demonstrated reduced resting pressure and the appearance of an irregular anal canal pressure wave after surgery. ICG angiography showed that the pudendal arteries provided more blood flow than the IMA to the anal segment. This is the first canine model of preliminary anorectal autotransplantation, and it demonstrates the possibility of establishing a transplantation model in dogs using appropriate vascular anastomoses, thus contributing to the progress of anorectal transplantation.
authors.affiliation: Department of Plastic Surgery, University of Tokyo, Tokyo, Japan. arakij-pla@h.u-tokyo.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakamura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Sato
authors.forename: Munekazu
authors.initials: M
authors.lastname: Naito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujii
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D001003:Anal Canal / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery / Q000637:transplantation*; D000818:Animals; D004285:Dogs; D005451:Fluorescein Angiography; D007208:Indocyanine Green / Q000378:metabolism; D008297:Male; D023421:Models, Animal; D011312:Pressure; D011859:Radiography; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery / Q000637:transplantation*; D014182:Transplantation, Autologous
chemical_list: D007208:Indocyanine Green