Freeman Lynetta J, Rahmani Emad Y, Sherman Stuart, Chiorean Michael V, Selzer Don J, Constable Peter D, Snyder Paul W
Purdue University School of Veterinary Medicine, West Lafayette, Indiana 47907, USA.
Gastrointest Endosc. 2009 Jun;69(7):1321-32. doi: 10.1016/j.gie.2008.10.028. Epub 2009 Feb 27.
Natural orifice transluminal endoscopic surgery (NOTES) represents a potentially less-invasive alternative to conventional or laparoscopic surgery.
Our purpose was to develop a canine oophorectomy model for prospective evaluation of intraoperative complications, surgical stress, and postoperative pain and recovery with NOTES.
Feasibility study.
Academic preclinical research.
Ten healthy female dogs.
NOTES procedures were performed through gastric access with an electrocautery snare to resect and retrieve the ovaries. The gastrotomy was closed with prototype T-fasteners.
Operative time; complications; postoperative pain scores, and nociceptive threshold; surgical stress markers (interleukin-6 [IL-6], C-reactive protein); systemic stress parameters (cortisol, glucose); necropsy evaluation at 10 to 14 days.
The mean operative time was 154 minutes (SD +/- 58 minutes) and no animals died as a result of complications from the procedure. The primary difficulty was incomplete ovarian excision and conversion to an open procedure in 1 dog. Serum glucose concentrations increased after surgery and remained elevated for at least 36 hours. The serum cortisol concentration was transiently increased from baseline at 2 hours after surgery. The serum IL-6 concentration peaked at 2 hours after surgery and returned to the baseline value by 18 hours. The serum C-reactive protein concentration increased significantly from baseline, peaked at 12 hours after surgery, and then slowly declined toward baseline but remained elevated at 72 hours after surgery. Nociceptive threshold measurements indicated increased sensitivity to pain for 2 to 24 hours after surgery. At necropsy, surgical sites were healing uneventfully with no significant damage to surrounding organs, no significant growth on bacterial cultures, and no evidence of peritonitis.
Small number of animals, single center.
The NOTES approach to oophorectomy in dogs appears to be a reasonable alternative to traditional surgery. Attention must be paid to ensure complete excision of the ovaries.
自然腔道内镜手术（NOTES）是一种相较于传统手术或腹腔镜手术潜在侵入性更小的替代方法。
我们的目的是建立一个犬卵巢切除术模型，用于前瞻性评估NOTES手术的术中并发症、手术应激、术后疼痛及恢复情况。
可行性研究。
学术性临床前研究。
10只健康雌性犬。
通过胃入路使用电灼圈套器进行NOTES手术，切除并取出卵巢。胃切开术用原型T形钉闭合。
手术时间；并发症；术后疼痛评分及伤害性感受阈值；手术应激标志物（白细胞介素-6 [IL-6]、C反应蛋白）；全身应激参数（皮质醇、葡萄糖）；术后10至14天尸检评估。
平均手术时间为154分钟（标准差±58分钟），无动物因手术并发症死亡。主要困难是1只犬卵巢切除不完全并转为开放手术。术后血清葡萄糖浓度升高并至少持续36小时保持在高位。血清皮质醇浓度在术后2小时从基线短暂升高。血清IL-6浓度在术后2小时达到峰值，18小时后恢复至基线值。血清C反应蛋白浓度从基线显著升高，术后12小时达到峰值，然后缓慢降至基线，但术后72小时仍高于基线。伤害性感受阈值测量表明术后2至24小时对疼痛的敏感性增加。尸检时，手术部位愈合良好，周围器官无明显损伤，细菌培养无显著生长，无腹膜炎迹象。
动物数量少，单中心研究。
犬NOTES卵巢切除术似乎是传统手术的合理替代方法。必须注意确保卵巢完全切除。
