Öz:Tümüyle deneysel olarak ortaya konmuş olan portokaval anastomoz sonrası üreter-mesane epitelindeki karsinogenezlsin mekanizması diyetteki karsinojenlerin karaciğer tarafından inaktive edilmemesi ile açıklanır. Bu deneysel çalışmada 8 köpekten oluşan 1. gruba yan-yana portokaval anastomoz, 2 gruba ise portokaval anastomoza ek olarak hepatik periarteriyel nörektomi uygulandı. Postop 21. gün relaparotomi yapılarak üreter ve mesane biyopsileri alındı. Feulgen-paraosanilin DNA boyasıyla görüntü analizi sonunda 1. grupta proliferasyon indeksi anlamlı olarak yüksek bulundu. Mevcut çalışma farklı deneysel model kullanılması, portokaval anastomozu takiben 3 hafta gibi erken postoperatif periodda artmış proliferatif indeks gibi preneoplastik ürotelial değişiklikler ve hepatik periarteriyel nörektominin bu değişiklikler üzerinde olumlu etkilerini ortaya koyması bakımından literatürde önceliklere sahiptir.
Abstract:The experimentally well documented mechanism of the urothelial carcinogenesis is related to not be able to inactivate of the dietary carcinogens by the liver after a portocaval anastomosis. In this experimental study, side to side portocaval anastomosis was performed on eight dog-group 1. Second group comprises seven dogs on which a hepatic periarteriel neurectomy was added to side to side portacaval shunt procedure. After a period of 3 weeks, relaparotomy was performed on all dogs and layers of ureter and bladder biopsies were taken. Image analysis with Feulgen- Pararosalyn DNA dye was completed and the proliferation index was found to be high in the first group (p<0.05) which was statistically significant. The present experimental study, first because of being a different dog experimental model, second because of the demonstration of the preneoplastic changes proved by the increased proliferation index even in the third week and thirdly because of the demonstration of the prohibiting effect of the hepatic periarteriel neurectomy upon these preneoplastic changes has a appreciative contribution to the literature.
