Hewitt Saundra A, Brisson Brigitte A, Sinclair Melissa D, Foster Robert A, Swayne Seanna-Lynn
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
J Am Vet Med Assoc. 2004 Jul 1;225(1):65-71. doi: 10.2460/javma.2004.225.65.
To evaluate feasibility of performing laparoscopic-assisted placement of a jejunostomy feeding tube (J-tube) and compare complications associated with placement, short-term feedings, and medium-term healing with surgically placed tubes in dogs.
Prospective study.
15 healthy mixed-breed dogs.
Dogs were randomly allocated to undergo open surgical or laparoscopic-assisted J-tube placement. Required nutrients were administered by a combination of enteric and oral feeding while monitoring for complications. Radiographic contrast studies documented tube direction and location, altered motility, or evidence of stricture.
Jejunostomy tubes were successfully placed in the correct location and direction in all dogs. In the laparoscopic group, the ileum was initially selected in 2 dogs, 2 dogs developed moderate hemorrhage at a portal site, and 2 J-tubes kinked during placement but were successfully readjusted postoperatively. All dogs tolerated postoperative feedings. All dogs developed minor ostomy site inflammation, and 1 dog developed bile-induced dermatitis at the ostomy site. Despite mild, transient neutrophilia, no significant difference was noted in WBC counts between groups. No dog had altered gastric motility or evidence of stricture, although the jejunopexy site remained identifiable in several dogs at 30 days.
Requirements for successful J-tube placement were met by use of a laparoscopic-assisted technique, and postoperative complications were mild and comparable to those seen with surgical placement. Laparoscopic-assisted J-tube placement compares favorably to surgical placement in healthy dogs and should be considered as an option for dogs requiring enterostomy feeding but not requiring a celiotomy for other reasons.
评估腹腔镜辅助放置空肠造口喂养管(J管)的可行性,并比较其与手术放置的管子在放置、短期喂养及中期愈合方面相关并发症在犬类中的情况。
前瞻性研究。
15只健康的混血犬。
犬只被随机分配接受开放式手术或腹腔镜辅助J管放置。通过肠内和口服喂养相结合的方式给予所需营养,同时监测并发症。X线造影研究记录管子的方向和位置、动力改变或狭窄证据。
所有犬只的空肠造口管均成功放置在正确的位置和方向。在腹腔镜组中,2只犬最初选择了回肠,2只犬在门静脉部位出现中度出血,2根J管在放置过程中发生扭结,但术后成功重新调整。所有犬只均耐受术后喂养。所有犬只均出现轻微的造口部位炎症,1只犬在造口部位出现胆汁性皮肤炎。尽管有轻度、短暂的中性粒细胞增多,但两组之间白细胞计数无显著差异。没有犬只出现胃动力改变或狭窄证据,尽管在30天时仍有几只犬的空肠固定部位可识别。
使用腹腔镜辅助技术满足了成功放置J管的要求,术后并发症轻微,与手术放置所见相当。在健康犬中,腹腔镜辅助J管放置与手术放置相比具有优势,对于需要肠造口喂养但因其他原因不需要开腹手术的犬只,应考虑将其作为一种选择。