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犬单孔后腹腔镜肾上腺切除术的可行性

Feasibility of single-port retroperitoneoscopic adrenalectomy in dogs.

作者信息

Ko Jonghyeok, Jeong Junemoe, Lee Sungin, Son Hyunglak, Kweon Oh-Kyeong, Kim Wan Hee

机构信息

Department of Veterinary Clinical Science, College of Veterinary Medicine and Research, Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.

出版信息

Vet Surg. 2018 Jun;47(S1):O75-O83. doi: 10.1111/vsu.12789. Epub 2018 Apr 26.

Abstract

OBJECTIVE

To evaluate the feasibility of single-port retroperitoneoscopic adrenalectomy (SPRA) in dogs.

STUDY DESIGN

A pilot experimental study.

ANIMALS

Eight healthy beagle dogs.

METHODS

SPRA was performed on the left and right sides (4 dogs each). Resection of the adrenal gland was performed through a SILS port using a retroperitoneal approach. Operative time was defined from skin incision to the completion of skin suture. Postoperative pain was evaluated by using 3 pain scores. Integrity of the adrenal gland capsule was evaluated by histologic assessment.

RESULTS

Mean time taken to complete the SPRA was 44.1 minutes (range, 37-51) and was significantly longer on the right side than on the left side (P < .05). There were no complications intraoperatively or during 14 days of postoperative monitoring. The adrenal gland capsule was found to be injured in 3 of the 8 dogs by histologic assessment.

CONCLUSION

This is the first report of SPRA in the veterinary literature. With this technique it is possible to perform adrenalectomy with some risk of capsule penetration and with excellent visibility.

CLINICAL SIGNIFICANCE

This study suggests that SPRA is feasible and can be used to resect small adrenal tumors with minimal complications.

摘要

目的

评估单孔后腹腔镜肾上腺切除术(SPRA)在犬类中的可行性。

研究设计

一项初步实验研究。

动物

8只健康的比格犬。

方法

在左右两侧均进行SPRA(各4只犬)。采用后腹腔镜入路,通过单孔腹腔镜手术(SILS)端口切除肾上腺。手术时间定义为从皮肤切口至皮肤缝合完成。使用3种疼痛评分评估术后疼痛。通过组织学评估肾上腺包膜的完整性。

结果

完成SPRA的平均时间为44.1分钟(范围为37 - 51分钟),右侧明显长于左侧(P < 0.05)。术中及术后14天的监测期间均未出现并发症。通过组织学评估发现,8只犬中有3只的肾上腺包膜受损。

结论

这是兽医文献中关于SPRA的首例报告。采用该技术进行肾上腺切除术存在一定的包膜穿透风险,但视野良好。

临床意义

本研究表明SPRA是可行的,可用于切除小的肾上腺肿瘤,并发症最少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af12/6032942/75a84c9cf725/VSU-47-O75-g001.jpg

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