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马剖腹术后网膜孔嵌顿的腹腔镜网膜孔评估

Laparoscopic Evaluation of the Epiploic Foramen after Celiotomy for Epiploic Foramen Entrapment in the Horse.

作者信息

van Bergen Thomas, Wiemer Peter, Schauvliege Stijn, Paulussen Ellen, Ugahary Franz, Martens Ann

机构信息

Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

De Lingehoeve Diergeneeskunde, Lienden, The Netherlands.

出版信息

Vet Surg. 2016 Jul;45(5):596-601. doi: 10.1111/vsu.12493. Epub 2016 Jun 14.

Abstract

OBJECTIVES

To evaluate the epiploic foramen using laparoscopy in horses previously treated for epiploic foramen entrapment to determine if spontaneous epiploic foramen closure had occurred.

STUDY DESIGN

Non-consecutive case series.

ANIMALS

Seven horses.

METHODS

The epiploic foramen was inspected by right flank laparoscopy between 35 and 71 days after successful surgical treatment for epiploic foramen entrapment. Data were collected on the presence of behavior vices, details of surgery for epiploic foramen entrapment (time from colic onset to surgery, site and length of entrapped intestine, direction of entrapment, compromise of the intestine, intestine resected), the time between surgery for epiploic foramen entrapment and laparoscopy, and the laparoscopic appearance of the epiploic foramen. If the epiploic foramen was open, a mesh was introduced to obliterate the epiploic foramen (Foramen Epiploicum Mesh Closure [FEMC]). Clinical progress of the horses was followed by owner telephone interview at 1 and 4 months after laparoscopy, and a final interview between 135 and 282 days after laparoscopy. Owners were questioned on specific postoperative complications and the exercise level of the horse.

RESULTS

At laparoscopy, 3/7 horses had complete closure of the epiploic foramen by dense fibrous tissue. The FEMC was performed in 4 horses without major complications. Postoperative colic episodes were recorded in 3 horses, all of them displaying windsucking/cribbing behavior.

CONCLUSION

Laparoscopic evaluation after celiotomy for epiploic foramen entrapment revealed spontaneous closure of the epiploic foramen in 3/7 horses. This finding could explain the reported low recurrence rate after surgical treatment for epiploic foramen entrapment.

摘要

目的

通过腹腔镜检查评估曾接受网膜孔嵌顿治疗的马匹的网膜孔,以确定是否发生了网膜孔的自发性闭合。

研究设计

非连续病例系列。

动物

7匹马。

方法

在成功进行网膜孔嵌顿手术治疗后的35至71天,通过右侧腹腹腔镜检查网膜孔。收集有关行为恶习的存在情况、网膜孔嵌顿手术的详细信息(从腹痛发作到手术的时间、被嵌顿肠段的部位和长度、嵌顿方向、肠段受损情况、切除的肠段)、网膜孔嵌顿手术与腹腔镜检查之间的时间,以及网膜孔的腹腔镜检查表现。如果网膜孔开放,则引入网片以闭塞网膜孔(网膜孔网片闭合术[FEMC])。在腹腔镜检查后的1个月和4个月通过业主电话访谈跟踪马匹的临床进展,并在腹腔镜检查后的135至282天进行最后一次访谈。询问业主有关特定的术后并发症和马匹的运动水平。

结果

在腹腔镜检查时,7匹马中有3匹的网膜孔被致密纤维组织完全闭合。4匹马进行了FEMC,无重大并发症。3匹马记录到术后腹痛发作,所有这些马都表现出吸风/咬槽行为。

结论

网膜孔嵌顿剖腹手术后的腹腔镜评估显示,7匹马中有3匹的网膜孔发生了自发性闭合。这一发现可以解释报道的网膜孔嵌顿手术治疗后较低的复发率。

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