Lund Caleb M, Ragle Claude A, Lutter J Dylan
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
J Am Vet Med Assoc. 2013 Nov 1;243(9):1323-8. doi: 10.2460/javma.243.9.1323.
An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week.
Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis.
A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery.
Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder.
对一匹11岁的阿拉伯种公马进行评估，该马出现血尿、排尿困难和尿频症状，已持续1周。
经直肠触诊发现膀胱内有一个5厘米大小的坚硬圆形肿块。膀胱镜检查和经直肠超声检查确诊为膀胱尿路结石。
选择多通道经腰旁窝腹腔镜手术入路进行膀胱切开取石术。在马站立状态下，通过镇静和局部麻醉进行膀胱切开取石术。未观察到围手术期并发症。术后5天排尿恢复正常。术后3周，该马恢复到术前的活动水平。
研究结果表明，微创经腰旁窝腹腔镜手术入路可成功用于站立马匹的膀胱切开取石术；这避免了传统剖腹膀胱切开术在雄性马属动物中取出大结石的缺点以及全身麻醉和恢复过程中的潜在并发症。该技术提供了良好的视野和进入膀胱的通道，能够取出尿路结石，并以最小的张力和对膀胱的组织损伤安全地缝合膀胱切口。
