Burke Megan J, Parente Eric J
Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania.
Vet Surg. 2016 Feb;45(2):201-7. doi: 10.1111/vsu.12434. Epub 2016 Jan 15.
To report surgical complications, occurrence of post-obliteration colic, long term outcome, and return to previous function for horses treated with prosthetic mesh obliteration of the nephrosplenic space.
Retrospective study.
Horses (n = 26) having nephrosplenic space obliteration using prosthetic mesh.
Horses undergoing mesh obliteration between January 2006 and May 2013 were included. A Proxplast™ mesh was secured to the nephrosplenic space with titanium helical coils in standing horses using laparoscopic technique. Perioperative data were obtained from the medical record and by telephone followup. Tests of proportion were used to compare the study population to the hospital colic population. Occurrence of colic within 1 year of obliteration was compared between horses where the diagnosis was confirmed at laparotomy and those diagnosed by abdominal palpation per rectum using a Fisher's exact test.
All 26 horses undergoing mesh obliteration during the study period survived to discharge. Long term followup was available for 25 horses, with 23 returning to their previous level of function, and 21 alive at the time of followup. Cause of death was not associated with the surgical procedure in any case. Geldings and Warmbloods were overrepresented compared to the hospital colic population. Ten horses (38%) demonstrated colic after mesh obliteration. All 10 horses were examined by a veterinarian and none were diagnosed with recurrence of nephrosplenic entrapment.
Mesh obliteration of the nephrosplenic space is an effective alternative to suture closure for preventing nephrosplenic entrapment of the large colon in horses. No complications related to mesh obliteration were reported in our study population.
报告采用人工合成网片闭塞肾脾间隙治疗马匹的手术并发症、闭塞后绞痛的发生率、长期预后以及恢复至先前功能的情况。
回顾性研究。
采用人工合成网片闭塞肾脾间隙的马匹(n = 26)。
纳入2006年1月至2013年5月间接受网片闭塞术的马匹。使用腹腔镜技术,在站立的马匹中将Proxplast™网片用钛螺旋线圈固定于肾脾间隙。围手术期数据从病历中获取,并通过电话随访收集。采用比例检验将研究群体与医院绞痛病例群体进行比较。使用Fisher精确检验比较剖腹探查确诊的马匹与经直肠腹部触诊确诊的马匹在闭塞后1年内绞痛的发生率。
研究期间接受网片闭塞术的26匹马均存活至出院。对25匹马进行了长期随访,其中23匹恢复至先前的功能水平,随访时21匹存活。在任何情况下,死亡原因均与手术操作无关。与医院绞痛病例群体相比,去势公马和温血马的比例过高。10匹马(38%)在网片闭塞术后出现绞痛。所有10匹马均由兽医进行了检查,无一被诊断为肾脾嵌顿复发。
对于预防马匹大结肠的肾脾嵌顿,肾脾间隙的网片闭塞术是一种有效的替代缝合闭合的方法。在我们的研究群体中未报告与网片闭塞相关的并发症。