Schönfelder Axel M, Sobiraj Axel
Large Animal Clinic for Theriogenology and Ambulatory Services, University of Leipzig, Leipzig, Germany.
Vet Surg. 2006 Feb;35(2):206-10. doi: 10.1111/j.1532-950X.2006.00133.x.
To report a technique for intra-partum ovariohysterectomy (OVH) in cows after severe uterine compromise after uterine torsion.
Clinical case report.
Four cows with uterine torsion.
After a ventrolateral cesarean section, uterine closure, and uterine detorsion, the laparotomy incision was elongated (20 cm) caudally so that the uterus can be completely exteriorized. The uterus was separated from broad ligaments by transection between 2 rows of overlapping interrupted sutures placed in the broad ligaments to a point approximately 2 cm caudal to the external os of the cervix. The vagina was occluded with 2 clamps directly caudal to the external os of the cervix and closed with 5 single cruciate sutures that penetrated all layers, and then the vagina was transected between the suture line and external os to remove the uterus. The abdominal incision was closed in layers. Results- All cows survived the surgery; however, 1 died the next day from Escherichia coli sepsis and 1 was euthanatized at 8 days because of unresponsive E. coli mastitis. One cow, 28 days after surgery developed a 15 cm perivaginal abscess, which resolved after drainage. This cow and the fourth cow survived and lactated.
Intra partum OVH is technically possible after cesarean section in cows with uterine compromise or necrosis after uterine torsion.
Ovariohysterectomy should be considered in cows with severe uterine torsion that have uterine tissue compromise to improve survival.
报告一种在母牛子宫扭转后子宫严重受损时进行分娩期卵巢子宫切除术(OVH)的技术。
临床病例报告。
四头患有子宫扭转的母牛。
在进行腹侧剖宫产、子宫缝合和子宫扭转复位后,将剖腹切口向尾侧延长(20厘米),以便将子宫完全移出体外。在阔韧带中两排重叠的间断缝合线之间进行横切,将子宫与阔韧带分离,直至子宫颈外口尾侧约2厘米处。在子宫颈外口正尾侧用两把夹子夹住阴道,并用5根穿透所有层的单十字缝线缝合,然后在缝线和子宫颈外口之间横切阴道以切除子宫。逐层关闭腹部切口。
所有母牛均在手术后存活;然而,1头母牛在第二天死于大肠杆菌败血症,1头母牛在第8天因无反应性大肠杆菌乳腺炎而被安乐死。1头母牛在手术后28天出现15厘米的阴道周围脓肿,引流后脓肿消退。这头母牛和第四头母牛存活并产奶。
对于子宫扭转后子宫受损或坏死的母牛,剖宫产术后在分娩期进行卵巢子宫切除术在技术上是可行的。
对于子宫严重扭转且子宫组织受损的母牛,应考虑进行卵巢子宫切除术以提高存活率。