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单切口腹腔镜辅助小肠手术与开腹手术治疗犬单纯性小肠异物取出术的疗效比较。

Comparison of outcome in dogs undergoing single-incision laparoscopic-assisted intestinal surgery and open laparotomy for simple small intestinal foreign body removal.

作者信息

Otomo Aki, Singh Ameet, Valverde Alexander, Beaufrere Hugues, Mrotz Victoria, Kilkenny Jessica, Linden Alex Zur

机构信息

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

Vet Surg. 2019 Jun;48(S1):O83-O90. doi: 10.1111/vsu.13131. Epub 2018 Nov 16.

Abstract

OBJECTIVE

To evaluate and compare outcome in dogs that underwent single-incision laparoscopic-assisted intestinal surgery (SILAIS) and open laparotomy (OL) for simple foreign body removal.

STUDY DESIGN

Retrospective study.

ANIMALS

Twenty-eight client-owned dogs that underwent SILAIS (n = 13) or OL (n = 15).

METHODS

Foreign body removal via SILAIS was performed with a commercially available single-port device. After laparoscopic evaluation, a wound retraction device (WRD) was inserted. The small intestine was extracorporeally explored, and foreign body removal was performed. The surgeon's hand was inserted through the WRD to palpate portions of the gastrointestinal tract not able to be extracorporeally evaluated. Open laparotomy with foreign body removal was performed via a ventral midline approach. Medical records were retrospectively reviewed, and perioperative data were collected. Follow-up data were collected with a standardized questionnaire with the referring veterinarian and/or owner via telephone interview.

RESULTS

No postoperative complications were encountered in either the SILAIS or the OL group, and all dogs were successfully discharged from the hospital. Conversion from SILAIS to OL occurred in 3/13 cases. There was no significant difference in duration of hospitalization, duration of time to recovery, or surgical time between surgical approaches (SILAIS vs OL).

CONCLUSION

Single-incision laparoscopic-assisted intestinal surgery for foreign body removal was not significantly different from OL in a variety of outcome measures in this cohort of dogs. Diagnostic imaging including ultrasonography or computed tomography may improve appropriate case selection for SILAIS for simple foreign body removal.

CLINICAL SIGNIFICANCE

Single-incision laparoscopic-assisted intestinal surgery offers a minimally invasive technique for simple small intestinal foreign body removal. Additional study is required to compare SILAIS with OL.

摘要

目的

评估并比较接受单切口腹腔镜辅助肠道手术(SILAIS)和开腹手术(OL)进行简单异物取出的犬只的预后情况。

研究设计

回顾性研究。

动物

28只客户拥有的犬只,其中13只接受了SILAIS,15只接受了OL。

方法

通过市售单孔装置进行SILAIS异物取出术。腹腔镜评估后,插入伤口牵开装置(WRD)。体外探查小肠并取出异物。外科医生的手通过WRD插入,以触诊无法体外评估的胃肠道部分。通过腹中线入路进行开腹异物取出术。回顾性查阅病历并收集围手术期数据。通过电话访谈向转诊兽医和/或主人发放标准化问卷收集随访数据。

结果

SILAIS组和OL组均未出现术后并发症,所有犬只均成功出院。13例中有3例从SILAIS转为OL。两种手术方式(SILAIS与OL)在住院时间、恢复时间或手术时间方面无显著差异。

结论

在这组犬只中,单切口腹腔镜辅助肠道异物取出术与开腹手术在多种预后指标上无显著差异。包括超声或计算机断层扫描在内的诊断成像可能有助于改善SILAIS用于简单异物取出的病例选择。

临床意义

单切口腹腔镜辅助肠道手术为简单的小肠异物取出提供了一种微创技术。需要进一步研究以比较SILAIS与OL。

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