Haraguchi Tomoya, Kimura Shiho, Itoh Harumichi, Nishikawa Shimpei, Hiyama Masato, Tani Kenji, Iseri Toshie, Itoh Yoshiki, Nakaichi Munekazu, Taura Yasuho, Itamoto Kazuhito
Laboratory of Veterinary Medical Center, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan.
Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan.
J Vet Med Sci. 2017 Sep 12;79(9):1524-1531. doi: 10.1292/jvms.17-0103. Epub 2017 Jul 17.
This study compared the effects of postoperative pain and inflammation reaction after preventive laparoscopic-assisted gastropexy (LAG) and incisional gastropexy (IG) in 10 clinically normal Beagles. Surgical time, incision length, visual analog scale (VAS) score, University of Melbourne Pain Scale (UMPS) score, and plasma C-reactive protein (CRP), plasma cortisol (COR), and serum interleukin-6 (IL-6) levels were evaluated. The VAS and UMPS scores and COR and IL-6 levels were recorded at 0.5, 1, 2, 4, 8, 12, 18 and 24 hr after surgery. CRP level was recorded at 12, 24 and 48 hr after surgery. The VAS and UMPS scores showed no significant intergroup differences. Compared to IG, LAG had significantly lower surgical time (45 ± 9.91 min vs 64 ± 5.30 min; P<0.05), incision length (46 ± 8.21 mm vs 129 ± 19.49 mm; P<0.05), CRP level (12 hr after surgery; 4.58 ± 1.58 mg/dl vs 12.4 ± 1.34 mg/dl; P<0.01), and COR level (1 hr after surgery; 10.79 ± 3.07 µg/dl vs 15.9 ± 3.77 µg/dl; P<0.05). IL-6 levels showed no significant intergroup differences at any time point. However, LAG resulted in lower IL-6 levels than did IG at all postoperative time points. Neither procedure resulted in significant surgical complications. LAG produced lower surgical stress than did IG, suggesting that LAG is a safe, minimally invasive, and highly useful technique for preventing canine gastric dilatation-volvulus. Nevertheless, since this study used experimental models, its usefulness should be evaluated in future cases.
本研究比较了预防性腹腔镜辅助胃固定术（LAG）和切开胃固定术（IG）对10只临床健康比格犬术后疼痛和炎症反应的影响。评估了手术时间、切口长度、视觉模拟评分（VAS）、墨尔本大学疼痛量表（UMPS）评分以及血浆C反应蛋白（CRP）、血浆皮质醇（COR）和血清白细胞介素-6（IL-6）水平。在术后0.5、1、2、4、8、12、18和24小时记录VAS和UMPS评分以及COR和IL-6水平。在术后12、24和48小时记录CRP水平。VAS和UMPS评分显示组间无显著差异。与IG相比，LAG的手术时间显著更短（45±9.91分钟对64±5.30分钟；P<0.05），切口长度显著更短（46±8.21毫米对129±19.49毫米；P<0.05），CRP水平（术后12小时；4.58±1.58毫克/分升对12.4±1.34毫克/分升；P<0.01），以及COR水平（术后1小时；10.79±3.07微克/分升对15.9±3.77微克/分升；P<0.05）。IL-6水平在任何时间点均无显著组间差异。然而，在所有术后时间点，LAG导致的IL-6水平均低于IG。两种手术均未导致显著的手术并发症。LAG产生的手术应激低于IG，表明LAG是预防犬胃扩张-扭转的一种安全、微创且非常有用的技术。然而，由于本研究使用的是实验模型，其有效性应在未来病例中进行评估。
