Bracamonte José L, Bouré Ludovic P, Geor Ray J, Runciman John R, Nykamp Stephanie G, Cruz Antonio M, Teeter Matthew G, Waterfall Heather L
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
Am J Vet Res. 2008 Mar;69(3):431-9. doi: 10.2460/ajvr.69.3.431.
To assess a technique for laparoscopic collection of serial full-thickness small intestinal biopsy specimens in horses.
13 healthy adult horses.
In the ex vivo portion of the study, sections of duodenum and jejunum obtained from 6 horses immediately after euthanasia were divided into 3 segments. Each segment was randomly assigned to the control group, the double-layer hand-sewn closure group, or the endoscopic linear stapler (ELS) group. Bursting strength and bursting wall tension were measured and compared among groups; luminal diameter reduction at the biopsy site was compared between the biopsy groups. In the in vivo portion of the study, serial full-thickness small intestinal biopsy specimens were laparoscopically collected with an ELS from the descending duodenum and distal portion of the jejunum at monthly intervals in 7 sedated, standing horses. Biopsy specimens were evaluated for suitability for histologic examination.
Mean bursting strength and bursting wall tension were significantly lower in the ELS group than in the hand-sewn and control groups in both the duodenal and jejunal segments. Use of the hand-sewn closure technique at the biopsy site reduced luminal diameter significantly more than use of the stapling technique. In the in vivo part of the study, all 52 biopsy specimens collected during 26 laparoscopic procedures were suitable for histologic examination and no clinically important perioperative complications developed.
Laparoscopic collection of serial full-thickness small intestinal biopsy specimens with a 45-mm ELS may be an effective and safe technique for use in healthy adult experimental horses.
评估一种用于腹腔镜采集马连续全层小肠活检标本的技术。
13匹健康成年马。
在研究的体外部分，对6匹马安乐死后立即获取的十二指肠和空肠段进行分割，分为3段。每段随机分配至对照组、双层手工缝合闭合组或内镜直线缝合器（ELS）组。测量并比较各组的破裂强度和破裂壁张力；比较活检组活检部位的管腔直径缩小情况。在研究的体内部分，对7匹镇静站立的马，每隔1个月通过ELS经腹腔镜从降部十二指肠和空肠远端采集连续全层小肠活检标本。评估活检标本是否适合组织学检查。
在十二指肠段和空肠段，ELS组的平均破裂强度和破裂壁张力均显著低于手工缝合组和对照组。在活检部位使用手工缝合闭合技术比使用缝合技术使管腔直径缩小更明显。在研究的体内部分，26次腹腔镜手术采集的52个活检标本均适合组织学检查，且未发生具有临床意义的围手术期并发症。
使用45毫米的ELS经腹腔镜采集马连续全层小肠活检标本，对于健康成年实验马可能是一种有效且安全的技术。
