Adamovich-Rippe Krista N, Mayhew Philipp D, Runge Jeffrey J, Culp William T N, Steffey Michele A, Mayhew Kelli N, Hunt Geraldine B
Department of Surgical and Radiological Sciences, University of California-Davis, Davis, CA 95616, USA.
Vet Surg. 2013 Jun;42(5):572-8. doi: 10.1111/j.1532-950X.2013.12012.x. Epub 2013 Apr 10.
To describe a technique for treating pyometra in dogs using a 3-portal laparoscopic-assisted ovariohysterectomy (LAOVH) and evaluate outcome.
Retrospective case series.
Dogs (n = 12).
Dogs with open or closed-cervix pyometra with moderately sized (1-4 cm) uterine horn diameters based on preoperative ultrasonography and no evidence of perforation were included in the study. A 3-portal technique for LAOVH was used. A wound retraction device was inserted into the caudal portal after enlargement of the incision to 3-4 cm to simplify removal of the uterus with minimal tension.
Twelve dogs (median weight, 23.3 kg; range, 2.1-46.0 kg) met the inclusion criteria. Median uterine diameter was 3.0 cm (range, 1.2-4.0 cm). Median surgical time for LAOVH was 107 minutes (range, 82-120 minutes). Complications included mild hemorrhage from the uterine vessels in 1 dog during uterine removal through the wound retraction device and intra-abdominal uterine rupture in 1 dog which necessitated conversion to an open approach. All dogs recovered from surgery and were discharged.
LAOVH can be used for treatment of select cases of canine pyometra. Careful case selection is mandatory to improve success and minimize conversion to an open approach. Gentle handling of the reproductive organs is imperative to avoid iatrogenic uterine rupture.
描述一种使用三通道腹腔镜辅助卵巢子宫切除术(LAOVH)治疗犬子宫蓄脓的技术,并评估其效果。
回顾性病例系列。
犬(n = 12)。
纳入术前超声检查显示子宫角直径中等大小(1 - 4厘米)、子宫颈开放或闭合性子宫蓄脓且无穿孔迹象的犬。采用三通道LAOVH技术。在将切口扩大至3 - 4厘米后,将伤口回缩装置插入尾侧通道,以简化子宫的取出,使张力最小化。
12只犬(中位体重,23.3千克;范围,2.1 - 至46.0千克)符合纳入标准。子宫中位直径为3.0厘米(范围,1.2 - 4.0厘米)。LAOVH的中位手术时间为107分钟(范围,82 - 120分钟)。并发症包括1只犬在通过伤口回缩装置取出子宫时子宫血管轻度出血,以及1只犬发生腹腔内子宫破裂,需转为开放手术。所有犬均从手术中恢复并出院。
LAOVH可用于治疗部分犬子宫蓄脓病例。必须仔细选择病例以提高成功率并尽量减少转为开放手术的情况。必须轻柔处理生殖器官以避免医源性子宫破裂。