Steiner A, Braun U, Waldvogel A
Department of Veterinary Surgery, University of Zürich, Switzerland.
Zentralbl Veterinarmed A. 1992 Feb;39(1):26-37. doi: 10.1111/j.1439-0442.1992.tb00153.x.
Two techniques for partial typhlectomy were evaluated on 20 cows each suffering from dilatation/torsion of the cecum. In a preliminary study on two cows the suitability of a stainless steel staple pattern using two TA 90 cartridges of 4.8 mm and 3.5 mm staples respectively was examined and the technique standardized. In the main clinical study the stapling pattern (group I) was compared with a simple continuous full thickness appositional suture oversewn with a continuous Cushing suture (group II). The cartridges with the 4.8 mm staples were used in 7 clinical cases, with intestinal wall edema and the 3.5 mm staples were used in 13 cases. Arterial bleeding from the cecal stump occurred in 20 out of 22 cases (including the results of the preliminary study). The number of arteries that had to be ligated was statistically significantly higher (p less than 0.05) with the 4.8 mm staples than with the 3.5 mm staples. The additional ligation of bleeding vessels prolonged the surgical procedure. Seventeen out of 20 cows (85%) of each group were discharged from the clinic. The duration of the hospital stay was 6 days for both groups. Fourteen cows (70%) of each group were still alive upon inquiry. One cow of the stapling group was slaughtered because of a severe fibrinous peritonitis at the resection site. In the other 11 cows there was no evidence of a connection between the surgery and the slaughtering.
对20头患有盲肠扩张/扭转的奶牛分别采用两种部分盲肠切除术技术进行评估。在对两头奶牛的初步研究中，检验了分别使用两个装有4.8毫米和3.5毫米吻合钉的TA 90钉仓的不锈钢吻合钉模式的适用性，并使该技术标准化。在主要临床研究中，将吻合钉模式（第一组）与用连续库欣缝合法缝合的简单连续全层对合缝线（第二组）进行比较。7例临床病例使用装有4.8毫米吻合钉的钉仓，这些病例存在肠壁水肿，13例使用3.5毫米吻合钉。22例病例（包括初步研究结果）中有20例盲肠残端出现动脉出血。使用4.8毫米吻合钉时，需要结扎的动脉数量在统计学上显著高于（p<0.05）使用3.5毫米吻合钉时。对出血血管的额外结扎延长了手术时间。每组20头奶牛中有17头（85%）出院。两组的住院时间均为6天。每组中有14头奶牛（70%）在随访时仍然存活。吻合钉组有1头奶牛因切除部位严重纤维蛋白性腹膜炎而被屠宰。在其他11头奶牛中，没有证据表明手术与屠宰之间存在关联。
