Mayhew Philipp D, Sutton Jessie S, Singh Ameet, Runge Jeffrey J, Case J Brad, Griffin Maureen A, Giuffrida Michelle A
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada.
Vet Surg. 2018 Jun;47(S1):O67-O74. doi: 10.1111/vsu.12752. Epub 2017 Nov 27.
To describe a technique and report complications and outcome for single-port laparoscopic splenectomy in dogs.
Retrospective study.
Twenty-two client-owned dogs.
Medical records of dogs that underwent single-port laparoscopic splenectomy at 4 veterinary teaching hospitals were evaluated. Commercially available single-port devices were used in all dogs. In all cases, a vessel-sealing device was used to perform a hilar splenectomy. After the procedure was completed, the spleen was exteriorized through the single-port device incision or placed into a specimen retrieval device; enlargement of the incision was required in some cases.
Median weight of dogs was 9.9 kg (interquartile range [IQR], 7.0-26.0). Splenectomy was performed because of splenic mass (n = 14), diffuse splenic disease (n = 4), or as adjunctive treatment for management of immune-mediated disease (n = 4). In cases with splenic masses, median maximal diameter of the largest splenic mass was 2.0 cm (IQR, 1.3-2.5). In 6 of 22 cases, mild splenic capsular bleeding occurred during the procedure. Conversion occurred in 6 of 22 cases to either a laparoscopic-assisted approach (n = 5) or an open celiotomy (n = 1). Reasons for conversion included large splenic dimensions (n = 3), adhesion formation (n = 1) or poor visualization resulting from abundant intra-abdominal fat (n = 1) or hemorrhage (n = 1). Heavier body weight was significantly associated with conversion (odds ratio, 1.62; 95% confidence interval, 1.05-2.51), but body condition score, having a splenic mass, splenic mass size, and surgical time were not.
Single-port laparoscopic splenectomy is an effective approach for elective splenectomy in dogs. The technique may be well suited to smaller dogs with modestly sized splenic masses or diffuse splenic disease.
描述犬单孔腹腔镜脾切除术的技术，并报告并发症及结果。
回顾性研究。
22只客户拥有的犬。
评估4家兽医教学医院接受单孔腹腔镜脾切除术的犬的病历。所有犬均使用市售单孔设备。所有病例均使用血管封闭装置进行脾门脾切除术。手术完成后，脾脏通过单孔设备切口取出或放入标本回收装置；部分病例需要扩大切口。
犬的中位体重为9.9 kg（四分位间距[IQR]，7.0 - 26.0）。行脾切除术的原因包括脾脏肿块（n = 14）、弥漫性脾脏疾病（n = 4）或作为免疫介导疾病治疗的辅助手段（n = 4）。脾脏肿块病例中，最大脾脏肿块的中位最大直径为2.0 cm（IQR，1.3 - 2.5）。22例中有6例在手术过程中出现轻度脾包膜出血。22例中有6例转为腹腔镜辅助手术（n = 5）或开腹手术（n = 1）。转换原因包括脾脏尺寸大（n = 3）、粘连形成（n = 1）或因腹腔内脂肪过多（n = 1）或出血（n = 1）导致视野不佳。体重较重与转换显著相关（优势比，1.62；95%置信区间，1.05 - 2.51），但身体状况评分、有脾脏肿块、脾脏肿块大小和手术时间则无此关联。
单孔腹腔镜脾切除术是犬择期脾切除术的有效方法。该技术可能非常适合脾脏肿块中等大小或患有弥漫性脾脏疾病的小型犬。
