Wittek Thomas, Locher Lena F, Alkaassem Ahmad, Constable Peter D
Medizinische Tierklinik der Universität Leipzig, Leipzig 04103, Germany.
J Am Vet Med Assoc. 2009 Mar 1;234(5):652-7. doi: 10.2460/javma.234.5.652.
To compare the effects of surgical correction of left displaced abomasum (LDA) by means of omentopexy via right flank laparotomy or 2-step laparoscopy-guided abomasopexy on postoperative abomasal emptying rate in lactating dairy cows.
Controlled clinical trial.
30 lactating dairy cows with an LDA.
Cows were alternately assigned to 2 groups of 15 cows each to receive surgical correction of LDA by means of 2-step laparoscopy-guided abomasopexy or omentopexy via right flank laparotomy. A 50% D-xylose solution (0.5 g/kg [0.23 g/lb]) was injected into the abomasal lumen during surgery. Jugular venous blood samples for determination of serum D-xylose concentration were periodically obtained after injection. Abomasal emptying rate was evaluated by pharmacokinetic determination of the time to modeled maximal serum D-xylose concentration (T(max-model)).
Mean +/- SD abomasal emptying rate was significantly faster after laparoscopy-guided abomasopexy (T(max-model), 192 +/- 51 minutes) than after omentopexy via right flank laparotomy (T(max-model), 264 +/- 94 minutes). Rumen contraction rate and milk yield increased faster after laparoscopy-guided abomasopexy, compared with values obtained after omentopexy; however, milk yield did not differ after the 2 procedures.
Amelioration of abomasal hypomotility after laparoscopy-guided abomasopexy rather than omentopexy via right flank laparotomy may result in faster clinical improvement in the immediate postoperative period in cows undergoing correction of an LDA.
比较经右侧肋腹剖腹术行网膜固定术或两步腹腔镜引导下皱胃固定术对左方变位皱胃（LDA）进行手术矫正后，泌乳奶牛术后皱胃排空率的影响。
对照临床试验。
30头患有LDA的泌乳奶牛。
奶牛被交替分配到两组，每组15头，分别接受通过两步腹腔镜引导下皱胃固定术或经右侧肋腹剖腹术行网膜固定术对LDA进行手术矫正。在手术过程中，将50%的D-木糖溶液（0.5 g/kg [0.23 g/lb]）注入皱胃腔。注射后定期采集颈静脉血样以测定血清D-木糖浓度。通过药代动力学测定模拟最大血清D-木糖浓度出现的时间（T(max-model)）来评估皱胃排空率。
腹腔镜引导下皱胃固定术后的平均±标准差皱胃排空率（T(max-model)，192±51分钟）显著快于经右侧肋腹剖腹术行网膜固定术后的排空率（T(max-model)，264±94分钟）。与网膜固定术后的值相比，腹腔镜引导下皱胃固定术后瘤胃收缩率和产奶量增加得更快；然而，两种手术术后的产奶量没有差异。
对于接受LDA矫正的奶牛，腹腔镜引导下皱胃固定术而非经右侧肋腹剖腹术行网膜固定术改善皱胃运动功能减弱的效果，可能会使术后即刻临床改善更快。
