Shaver Stephanie L, Mayhew Philipp D, Steffey Michele A, Hunt Geraldine B, Mayhew Kelli N, Culp William T N
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Vet Surg. 2015 Jul;44 Suppl 1:71-5. doi: 10.1111/j.1532-950X.2014.12312.x. Epub 2014 Dec 18.
To describe surgical techniques for multiple port laparoscopic splenectomy (MLS) in dogs and report short-term outcome.
Retrospective case series.
Dogs (n = 10) with naturally occurring splenic disease.
Medical records (March 2012-March 2013) of dogs that had MLS were reviewed. Data retrieved included signalment, weight, clinical signs, physical examination findings, preoperative laboratory and ultrasonographic findings, port number, size, and location, patient positioning, additional procedures performed, surgical duration, histopathologic diagnosis, duration of hospitalization, and perioperative complications.
Ten dogs (median weight, 28.7 kg; range, 20.2-46.0 kg) had MLS using a 3 or 4 port technique and a vessel-sealing device for tissue dissection along the splenic hilus. Dog positioning varied because of additional laparoscopic or laparoscopic-assisted procedures including adrenalectomy (n = 2), ovariectomy (1), gastropexy (1), and intestinal resection and anastomosis (1). Conversion to an open approach was necessary in 1 dog because of inadequate visibility caused by omental adhesions. One dog had hemorrhage from an omental vessel, but open conversion was not required.
MLS was associated with little perioperative morbidity and few complications in this cohort of dogs and may be a reasonable option for surgical management of dogs requiring elective splenectomy.
描述犬多端口腹腔镜脾切除术(MLS)的手术技术并报告短期结果。
回顾性病例系列。
患有自然发生的脾脏疾病的犬(n = 10)。
回顾2012年3月至2013年3月接受MLS的犬的病历。检索的数据包括特征、体重、临床症状、体格检查结果、术前实验室和超声检查结果、端口数量、大小和位置、患者体位、进行的其他手术、手术持续时间、组织病理学诊断、住院时间和围手术期并发症。
10只犬(中位体重28.7 kg;范围20.2 - 46.0 kg)采用3或4端口技术及血管封闭装置沿脾门进行组织分离,实施了MLS。由于包括肾上腺切除术(n = 2)、卵巢切除术(1)、胃固定术(1)和肠切除吻合术(1)在内的其他腹腔镜或腹腔镜辅助手术,犬的体位有所不同。1只犬因网膜粘连导致视野不佳,需要转为开放手术。1只犬网膜血管出血,但无需转为开放手术。
在这组犬中,MLS围手术期发病率低,并发症少,对于需要择期脾切除术的犬的手术管理可能是一个合理的选择。