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正常犬腹腔镜及腹腔镜辅助手术中使用标准内镜器械与超声刀获取活检样本的比较。

Comparison of biopsy samples obtained using standard endoscopic instruments and the harmonic scalpel during laparoscopic and laparoscopic-assisted surgery in normal dogs.

作者信息

Barnes Roy F, Greenfield Cathy L, Schaeffer David J, Landolfi Jennifer, Andrews John

机构信息

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA.

出版信息

Vet Surg. 2006 Apr;35(3):243-51. doi: 10.1111/j.1532-950X.2006.00134.x.

Abstract

OBJECTIVES

To compare tissue specimens of canine abdominal organs collected by standard techniques (ST) and harmonic scalpel (HS) and to determine the effect of each technique on wound healing.

STUDY DESIGN

Experimental.

ANIMALS

Twelve dogs.

METHODS

Paired biopsy samples (ST, HS) were collected from liver, spleen, adrenal gland, pancreas, stomach, jejunum, and bladder using laparoscopic or laparoscopic-assisted methods. Hemorrhage at biopsy sites was assessed (present or absent). Specimens were evaluated for diagnostic quality and histologic changes. Dogs were necropsied at 4 or 14 days postoperatively.

RESULTS

HS incision caused less frequent hemorrhage of all organs except spleen. HS specimens had more coagulation necrosis than ST specimens, but both techniques yielded specimens that were sized similarly and were of diagnostic quality. At necropsy, HS biopsy sites of the stomach, jejunum, bladder, adrenal gland, and pancreas were more hyperemic than ST sites. There were more adhesions at jejunal and pancreatic ST biopsy sites. HS biopsy sites had more coagulation necrosis at days 4 and 14 postoperatively. Differences in fibrin deposition, inflammation, and fibrosis were present at biopsy sites of some organs at days 4 or 14 and in comparisons between days 4 and 14.

CONCLUSIONS

Diagnostic quality biopsy specimens were obtained with HS and ST. Although HS-induced gross and histologic changes during the first 2 postoperative weeks, no clinical complications were observed.

CLINICAL RELEVANCE

Both HS and ST can yield specimens with minimal hemorrhage and HS resulted in no apparent postoperative problems in normal dogs. Although HS caused more inflammation and adhesions at biopsy sites of the pancreas, adrenal gland, and jejunum, no clinical complications occurred.

摘要

目的

比较采用标准技术(ST)和超声刀(HS)采集的犬腹部器官组织标本,并确定每种技术对伤口愈合的影响。

研究设计

实验性研究。

动物

12只犬。

方法

采用腹腔镜或腹腔镜辅助方法,从肝脏、脾脏、肾上腺、胰腺、胃、空肠和膀胱采集配对的活检样本(ST、HS)。评估活检部位的出血情况(有或无)。对标本进行诊断质量和组织学变化评估。术后4天或14天对犬进行尸检。

结果

除脾脏外,HS切口导致所有器官出血的频率较低。HS标本的凝固性坏死比ST标本更多,但两种技术获得的标本大小相似且具有诊断质量。尸检时,胃、空肠、膀胱、肾上腺和胰腺的HS活检部位比ST部位充血更明显。空肠和胰腺ST活检部位的粘连更多。HS活检部位在术后第4天和第第14天有更多的凝固性坏死。在术后第4天或第14天,一些器官的活检部位以及第4天和第14天的比较中,纤维蛋白沉积、炎症和纤维化存在差异。

结论

HS和ST均获得了具有诊断质量的活检标本。虽然HS在术后前2周引起了大体和组织学变化,但未观察到临床并发症。

临床意义

HS和ST均可获得出血极少的标本,且HS在正常犬中未导致明显的术后问题。虽然HS在胰腺、肾上腺和空肠的活检部位引起了更多炎症和粘连,但未发生临床并发症。

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