Rumbaugh Marilyn L, Burba Daniel J, Natalini Claudio, Hosgood Giselle, Moore Rustin M
Equine Health Studies Program, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
Vet Surg. 2003 Nov-Dec;32(6):574-9. doi: 10.1111/j.1532-950x.2003.00574.x.
To compare arterial bursting pressure after vessel closure using a vessel-sealing device (LigaSure Atlas Laparoscopic Sealer/Divider Instrument; Valleylab, Boulder, CO), a ligate-and-divide stapling device (LDS), and 2-0 polydioxanone suture. To evaluate the LigaSure Atlas as a method for ligation of the mesenteric vasculature during small intestinal resection in normal horses.
Experimental study.
Part A: jejunal segments from 19 horses. Part B: 6 horses, aged 1 to 18 years, weighing 330 to 509 kg.
Part A: Jejunal segments with mesenteric vessels were collected from 19 horses. After closure by 1 of 3 methods (LigaSure Atlas, LDS, 2-0 polydioxanone) arteries were cannulated, and bursting pressure was measured by incrementally increasing intraluminal pressure until failure. Part B: Six horses had jejunal resection and anastomosis using a vessel-sealing device (LigaSure Atlas) to provide hemostasis of the mesenteric vasculature. Horses were monitored clinically for 4 weeks.
Part A: Mean +/- SEM bursting pressure after 2-0 polydioxanone ligation (1,014.50 +/- 279.05 mm Hg) was significantly greater than mean bursting pressure after LigaSure (554.25 +/- 228.79 mm Hg), which was significantly greater than the mean bursting pressure after LDS (373.25 +/- 183.69). Part B: No major operative or postoperative hemorrhage occurred after application of the LigaSure Atlas for sealing and transecting mesenteric vasculature during small intestinal resection in normal horses.
The LigaSure Atlas appears to be a safe method for hemostasis of the mesenteric vasculature during small intestinal resection in normal horses.
Benefits of the LigaSure Atlas vessel-sealing device include reduced time required to provide hemostasis, acceptable arterial bursting pressure, no remaining foreign material, and no risk for ligature slippage. In our experience, use of the LigaSure Atlas during small intestinal resection and anastomosis in horses is safe for ligation of vessels less than or equal to 7-mm diameter.
比较使用血管闭合装置（LigaSure Atlas腹腔镜闭合器/切割器；美国科罗拉多州博尔德市威利雅公司）、结扎并切割吻合器（LDS）和2-0聚二氧杂环己酮缝线进行血管闭合后的动脉破裂压力。评估LigaSure Atlas作为正常马小肠切除术中肠系膜血管结扎方法的效果。
实验研究。
A部分：19匹马的空肠段。B部分：6匹马，年龄1至18岁，体重330至509千克。
A部分：从19匹马收集带有肠系膜血管的空肠段。用三种方法之一（LigaSure Atlas、LDS、2-0聚二氧杂环己酮）闭合后，将动脉插管，通过逐渐增加管腔内压力直至破裂来测量破裂压力。B部分：6匹马进行空肠切除和吻合术，使用血管闭合装置（LigaSure Atlas）来实现肠系膜血管的止血。对马进行4周的临床监测。
A部分：2-0聚二氧杂环己酮结扎后的平均±标准误破裂压力（1,014.50±279.05毫米汞柱）显著高于LigaSure后的平均破裂压力（554.25±228.79毫米汞柱），LigaSure后的平均破裂压力又显著高于LDS后的平均破裂压力（373.25±183.69）。B部分：在正常马小肠切除术中应用LigaSure Atlas闭合和横断肠系膜血管后，未发生重大手术或术后出血。
LigaSure Atlas似乎是正常马小肠切除术中肠系膜血管止血的一种安全方法。
LigaSure Atlas血管闭合装置的优点包括止血所需时间减少、可接受的动脉破裂压力、无残留异物以及无结扎滑脱风险。根据我们的经验，在马的小肠切除和吻合术中使用LigaSure Atlas对直径小于或等于7毫米的血管进行结扎是安全的。
