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简化的微创外科手术方法用于21例预防性腹腔镜胃固定术

Simplified Minimally Invasive Surgical Approach for Prophylactic Laparoscopic Gastropexy in 21 Cases.

作者信息

Deroy Claire, Hahn Harriet, Bismuth Camille, Ragetly Guillaume, Gomes Eymeric, Poncet Cyrill

机构信息

From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.).

出版信息

J Am Anim Hosp Assoc. 2019 May/Jun;55(3):152-159. doi: 10.5326/JAAHA-MS-6879. Epub 2019 Mar 14.

DOI:10.5326/JAAHA-MS-6879
PMID:30870607
Abstract

The objective of this study was to describe the operative technique and outcome of a simplified laparoscopic gastropexy approach in dogs. Twenty-one dogs undergoing prophylactic laparoscopic gastropexy with a simple continuous barbed suture without incising the seromuscular layer of the stomach and transversus abdominis muscle were reviewed. In 20 cases, additional procedures were performed (18 ovariectomies and 2 prescrotal castrations); 1 dog had two prior episodes of gastric dilation without volvulus and underwent gastropexy with a prophylactic intent. The gastropexy procedure had a median duration of 33 min (range 19-43 min). V-Loc 180 absorbable and the V-Loc PBT nonabsorbable suturing devices were used in 8 and 13 dogs, respectively. Minor intraoperative complications occurred in four cases: broken suture (1), needle dislodgement (2), and folded needle (1). Minor complications included self-limiting wound complications (3), abdominal discomfort (2), vomiting (1), and inappetence (2). Postoperative abdominal ultrasound performed after a median of 8 mo (6-36 mo) confirmed permanent adhesion at the gastropexy site in all dogs. One dog developed a fistula (1 yr postoperatively) and another a granuloma (3 mo postoperatively), both at the gastropexy site. Prophylactic laparoscopic gastropexy may be performed with knotless unidirectional barbed suture without creating an incision on the abdominal wall and stomach.

摘要

本研究的目的是描述一种简化的腹腔镜胃固定术在犬类中的手术技术及结果。对21只接受预防性腹腔镜胃固定术的犬进行了回顾,该手术采用简单连续倒刺缝线,未切开胃和腹横肌的浆膜肌层。20例病例还进行了其他手术(18例卵巢切除术和2例阴囊前阉割术);1只犬曾有2次非扭转性胃扩张发作,此次接受胃固定术是出于预防目的。胃固定术的中位持续时间为33分钟(范围19 - 43分钟)。分别有8只和13只犬使用了V-Loc 180可吸收缝合装置和V-Loc PBT不可吸收缝合装置。术中发生了4例轻微并发症:缝线断裂(1例)、缝针移位(2例)和缝针折叠(1例)。轻微并发症包括自限性伤口并发症(3例)、腹部不适(2例)、呕吐(1例)和食欲不振(2例)。术后中位8个月(6 - 36个月)进行的腹部超声检查证实,所有犬的胃固定部位均有永久性粘连。1只犬在术后1年出现胃固定部位瘘管,另1只犬在术后3个月出现胃固定部位肉芽肿。预防性腹腔镜胃固定术可采用无结单向倒刺缝线进行,无需在腹壁和胃上做切口。

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