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犬内镜辅助胃固定术后短期和长期并发症的评估

Evaluation of short- and long-term complications after endoscopically assisted gastropexy in dogs.

作者信息

Dujowich Mauricio, Keller Mattew E, Reimer S Brent

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.

出版信息

J Am Vet Med Assoc. 2010 Jan 15;236(2):177-82. doi: 10.2460/javma.236.2.177.

Abstract

OBJECTIVE

To determine short- and long-term complications in clinically normal dogs after endoscopically assisted gastropexy.

DESIGN

Prospective case series.

ANIMALS

24 dogs.

PROCEDURES

Endoscopically assisted gastropexy was performed on each dog. Dogs were evaluated laparoscopically at 1 or 6 months after surgery to assess integrity of the gastropexy. Long-term outcome was determined via telephone conversations conducted with owners > or = 1 year after surgery.

RESULTS

Mean +/- SD gastropexy length was 4.5 +/- 0.9 cm, and mean duration of surgery was 22 +/- 5 minutes. One dog had a partially rotated stomach at the time of insufflation, which was corrected by untwisting the stomach with Babcock forceps. Two dogs vomited within 4 weeks after surgery, but the vomiting resolved in both dogs. Four dogs had diarrhea within 4 weeks after surgery, which resolved without medical intervention. In all dogs, the gastropexy site was firmly adhered to the abdominal wall at the level of the pyloric antrum. Long-term follow-up information was available for 23 dogs, none of which had any episodes of gastric dilatation-volvulus a mean of 1.4 years after gastropexy.

CONCLUSIONS AND CLINICAL RELEVANCE

Endoscopically assisted gastropexy can be a simple, fast, safe, and reliable method for performing prophylactic gastropexy in dogs. At 1 and 6 months after gastropexy, adequate placement and adhesion of the gastropexy site to the body wall was confirmed. Such a procedure could maximize the benefits of minimally invasive surgery, such as decreases in morbidity rate and anesthetic time. This technique appeared to be suitable as an alternative to laparoscopic-assisted gastropexy.

摘要

目的

确定经内镜辅助胃固定术后临床正常犬的短期和长期并发症。

设计

前瞻性病例系列。

动物

24只犬。

步骤

对每只犬实施经内镜辅助胃固定术。术后1个月或6个月对犬进行腹腔镜检查,以评估胃固定的完整性。通过术后≥1年与犬主进行电话沟通来确定长期预后。

结果

胃固定平均长度±标准差为4.5±0.9 cm,平均手术持续时间为22±5分钟。1只犬在充气时胃发生部分扭转,用巴布科克钳扭转胃后得以纠正。2只犬在术后4周内出现呕吐,但两只犬的呕吐均得到缓解。4只犬在术后4周内出现腹泻,未经药物治疗自行缓解。所有犬的胃固定部位在幽门窦水平均牢固地附着于腹壁。23只犬有长期随访信息,胃固定术后平均1.4年,无一发生胃扩张-扭转。

结论及临床意义

经内镜辅助胃固定术可作为犬预防性胃固定术的一种简单、快速、安全且可靠的方法。胃固定术后1个月和6个月,证实胃固定部位放置合适且与体壁粘连良好。该手术可使微创手术的益处最大化,如降低发病率和缩短麻醉时间。该技术似乎适合作为腹腔镜辅助胃固定术的替代方法。

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