Pavia P R, Kovak-McClaran J, Lamb K
Department of Surgery, Animal Medical Center, New York, NY, 10065, USA.
J Small Anim Pract. 2014 Jan;55(1):22-7. doi: 10.1111/jsap.12158. Epub 2013 Nov 27.
To present outcomes and complications following liver lobectomy using thoracoabdominal staplers in cats, to identify factors associated with survival time and to confirm safety and feasibility.
Retrospective analysis of case records (n=18) of cats that underwent liver lobectomy with a thoracoabdominal stapler.
Fourteen of the 18 cats (78%) survived to discharge. Median survival time was 136·5 days. On log-rank univariate analysis, preoperative abdominal fluid (P=0·002), preoperative anaemia (P=0·03) and perioperative transfusion (P=0·01) were associated with decreased survival time. Perioperative anaemia was common (89%), and rate of transfusion during hospitalisation was 61%. Clinical signs of illness, azotaemia, elevated liver enzyme activities and malignant neoplasia did not appear to impact survival; however, anaemia, abdominal fluid and transfusion may be associated with decreased survival time.
Liver lobectomy using thoracoabdominal staplers was effective in removal of hepatic lesions and all cats survived surgery. Outcome was negatively associated with preoperative abdominal fluid (haemorrhagic and non-haemorrhagic), preoperative anaemia or perioperative transfusion. Surgeons should be prepared to employ ancillary methods of haemostasis to augment the staple line, and need for blood transfusion should be anticipated.
介绍使用胸腹吻合器对猫进行肝叶切除术后的结果和并发症,确定与生存时间相关的因素,并确认安全性和可行性。
对18只使用胸腹吻合器进行肝叶切除的猫的病例记录进行回顾性分析。
18只猫中有14只(78%)存活至出院。中位生存时间为136.5天。在对数秩单因素分析中,术前腹腔积液(P = 0.002)、术前贫血(P = 0.03)和围手术期输血(P = 0.01)与生存时间缩短相关。围手术期贫血很常见(89%),住院期间输血率为61%。疾病的临床症状、氮血症、肝酶活性升高和恶性肿瘤似乎对生存没有影响;然而,贫血、腹腔积液和输血可能与生存时间缩短有关。
使用胸腹吻合器进行肝叶切除在切除肝脏病变方面有效,所有猫均存活至手术结束。结果与术前腹腔积液(出血性和非出血性)、术前贫血或围手术期输血呈负相关。外科医生应准备好采用辅助止血方法加强吻合钉线,并应预计到输血的需求。