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犬类尸体模型中经皮放射胃固定术技术的描述及生物力学比较

Description and Biomechanical Comparison of a Percutaneous Radiologic Gastropexy Technique in a Canine Cadaver Model.

作者信息

Culp William T N, Balsa Ingrid M, Kim Sun Y, Glaiberman Craig B, Grimes Millie, Mayhew Philipp D, Johnson Eric G, Palm Carrie A, Garcia Tanya C, Kass Philip H

机构信息

Department of Surgical and Radiological Sciences, Davis, California.

Sutter Imaging, Interventional Radiology, Sacramento, California.

出版信息

Vet Surg. 2016 May;45(4):456-63. doi: 10.1111/vsu.12475. Epub 2016 Apr 18.

Abstract

OBJECTIVE

To describe a novel percutaneous radiologic gastropexy (PRG) technique in a canine model and to biomechanically compare this technique to open incisional gastropexy (OIG) and laparoscopic-assisted incisional gastropexy (LAG).

STUDY DESIGN

Randomized ex vivo biomechanical study.

ANIMALS

Canine cadavers.

METHODS

Fifteen cadavers were randomized to 1 of 3 surgical interventions: OIG, LAG, and PRG. For the PRG procedure, the stomach was distended with air, and a preloaded T-fastener device was utilized to attach the stomach to the body wall with fluoroscopic-guidance. The procedural times of the 3 techniques were recorded. After completion of the procedure, the stomach and body wall overlying the stomach wall were harvested and the maximum tensile strength of the gastropexies was determined.

RESULTS

The maximal tensile strength was not significantly different between groups. The total procedural time for the PRG procedure (5 minutes) was significantly shorter than both OIG (28 minutes) and LAG (20 minutes) procedures.

CONCLUSION

The PRG technique described in this study demonstrated a similar maximal tensile strength to commonly employed gastropexy techniques (OIG and LAG) in an acute canine model. Additionally, the PRG procedure was significantly faster to perform. The clinical relevance of this technique will be determined by further study to assess the applicability and efficacy of this procedure in clinical patients by determining the likelihood of adhesion development and the ability of the adhesion to prevent gastric volvulus.

摘要

目的

在犬类模型中描述一种新型经皮放射学胃固定术(PRG)技术,并对该技术与开放式切口胃固定术(OIG)和腹腔镜辅助切口胃固定术(LAG)进行生物力学比较。

研究设计

随机离体生物力学研究。

动物

犬类尸体。

方法

15具尸体被随机分配至3种手术干预中的一种:OIG、LAG和PRG。对于PRG手术,向胃内充入空气,使用预加载的T形钉装置在荧光透视引导下将胃固定于体壁。记录这3种技术的手术时间。手术完成后,获取胃及覆盖胃壁的体壁,测定胃固定术的最大拉伸强度。

结果

各组间最大拉伸强度无显著差异。PRG手术的总手术时间(5分钟)显著短于OIG(28分钟)和LAG(20分钟)手术。

结论

本研究中描述的PRG技术在急性犬类模型中显示出与常用胃固定术(OIG和LAG)相似的最大拉伸强度。此外,PRG手术的执行速度明显更快。该技术的临床相关性将通过进一步研究来确定,即通过确定粘连形成的可能性以及粘连预防胃扭转的能力来评估该手术在临床患者中的适用性和疗效。

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