Hunter Barbara G, Huber Michael J, Riddick Tara L
Veterinary Teaching Hospital, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA.
J Am Vet Med Assoc. 2012 Sep 15;241(6):778-81. doi: 10.2460/javma.241.6.778.
A 5-year-old castrated male Nigerian Dwarf goat with recurrent urethral obstruction after perineal urethrostomy.
The wether goat was referred for evaluation of a perineal urethrostomy site; perineal urethrostomy had been performed 1.5 years earlier. The site was patent, but a moderate stricture was found just cranial to the perineal urethrostomy site. The goat had obstructed urine flow at the stricture site repeatedly in the previous few months.
Laparoscopically assisted urinary bladder marsupialization was recommended. The procedure was performed with the patient under general anesthesia in dorsal recumbency; food had been withheld for 36 hours prior to anesthesia. Ventral midline and left caudal paramedian portals were made for the laparoscopic camera and instruments. A larger incision in the right caudal paramedian portion of the abdomen was used to create the marsupialization stoma. Laparoscopic observation of anatomic structures within the abdomen was excellent. The goat recovered well from surgery and was discharged the day following surgery. Follow-up examinations were done every few months after surgery, and dermatitis of the abdominal skin secondary to urine scald was the only postoperative complication. At 9 months of follow-up, the goat continued to pass urine through the marsupialization site comfortably.
In the goat of this report, laparoscopic urinary bladder marsupialization was a minimally invasive procedure with minimal signs of postoperative pain. The procedure was simple to perform and should be considered as an alternative to marsupialization via laparotomy.
一只5岁去势的尼日利亚矮种公山羊，会阴尿道造口术后反复出现尿道梗阻。
这只阉公羊因会阴尿道造口部位评估前来就诊；会阴尿道造口术于1.5年前进行。造口部位通畅，但在会阴尿道造口部位头侧发现中度狭窄。在过去几个月里，这只山羊在狭窄部位反复出现尿流梗阻。
建议行腹腔镜辅助膀胱造袋术。手术在全身麻醉下患者仰卧位时进行；麻醉前禁食36小时。在腹中线和左尾旁正中部位做切口用于置入腹腔镜摄像头和器械。在腹部右尾旁正中部分做一个更大的切口用于创建造袋口。腹腔镜对腹内解剖结构的观察效果良好。这只山羊术后恢复良好，术后第二天出院。术后每隔几个月进行随访检查，尿烫伤继发的腹部皮肤皮炎是唯一的术后并发症。随访9个月时，这只山羊继续通过造袋口舒适地排尿。
在本报告的山羊中，腹腔镜膀胱造袋术是一种微创手术，术后疼痛迹象轻微。该手术操作简单，应被视为剖腹造袋术的替代方法。
