Cribb Nicola C, Koenig Judith, Sorge Ulrike
From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
J Am Vet Med Assoc. 2015 Apr 15;246(8):885-92. doi: 10.2460/javma.246.8.885.
Objective-To compare surgical preparation time, surgery and anesthesia times, hospitalization duration, and intra- and postoperative complications between laparoscopic and conventional open cryptorchidectomy in horses. Design-Retrospective cohort study. Animals-60 horses that underwent cryptorchidectomy. Procedures-Medical records were reviewed to identify horses that had undergone cryptorchidectomy from 1991 to 2012. Thirty horses that underwent laparoscopic cryptorchidectomy (case horses) were matched with 30 control horses that had undergone open cryptorchidectomy (ie, inguinal and parainguinal surgical approaches). Horses were matched according to history of previous surgery, testicle location, and type of closure following removal of an undescended unilateral testicle. Duration of surgery, surgical preparation and anesthesia times, hospitalization duration, and number of intra- and postoperative complications were compared between horses that underwent laparoscopic cryptorchidectomy versus open cryptorchidectomy. Comparisons were also made between horses in terms of whether there was a history of previous failed cryptorchidectomy or unknown location of testicle prior to surgery. Results-Horses that underwent laparoscopic cryptorchidectomy had significantly longer surgery and anesthesia times overall, compared with horses that underwent open cryptorchidectomy. No difference in surgery time was found between case and control horses that had a previous surgical attempt to remove an undescended testicle or in which the testicle location was unknown prior to surgery. Overall, horses undergoing laparoscopy had a nonsignificant increase in intraoperative complications, compared with control horses, and had significantly more postoperative complications. Conclusions and Clinical Relevance-Horses undergoing laparoscopic cryptorchidectomy had increased surgical preparation time, increased surgery and anesthesia times, and more postoperative complications, compared with horses undergoing open cryptorchictomy. Laparoscopy may be advantageous for a second attempt at cryptorchidectomy or if the testicle location is unknown prior to surgery.
目的——比较马腹腔镜隐睾切除术与传统开放式隐睾切除术的手术准备时间、手术及麻醉时间、住院时长以及术中和术后并发症。
设计——回顾性队列研究。
动物——60匹接受隐睾切除术的马。
步骤——查阅病历，以确定1991年至2012年间接受隐睾切除术的马。30匹接受腹腔镜隐睾切除术的马（病例组马）与30匹接受开放式隐睾切除术（即腹股沟和腹股沟旁手术入路）的对照马进行匹配。根据既往手术史、睾丸位置以及单侧隐睾切除术后的缝合类型对马进行匹配。比较接受腹腔镜隐睾切除术的马与开放式隐睾切除术的马的手术时长、手术准备及麻醉时间、住院时长以及术中和术后并发症数量。还比较了马在既往隐睾切除术失败史或术前睾丸位置不明方面的情况。
结果——与接受开放式隐睾切除术的马相比，接受腹腔镜隐睾切除术的马总体手术及麻醉时间明显更长。在既往有手术尝试切除隐睾或术前睾丸位置不明的病例组马与对照马之间，未发现手术时间存在差异。总体而言，与对照马相比，接受腹腔镜检查的马术中并发症有非显著性增加，且术后并发症明显更多。
结论及临床意义——与接受开放式隐睾切除术的马相比，接受腹腔镜隐睾切除术的马手术准备时间增加、手术及麻醉时间增加且术后并发症更多。对于再次尝试隐睾切除术或术前睾丸位置不明的情况，腹腔镜检查可能具有优势。
