Hlusko Katelyn C, Hansen Sonya C, Matz Brad M, Bacek Lenore M, Boothe Harry W, Bellah Jamie R, Tillson D Michael
Auburn University College of Veterinary Medicine, Auburn, AL.
J Vet Emerg Crit Care (San Antonio). 2019 Sep;29(5):564-567. doi: 10.1111/vec.12884. Epub 2019 Aug 19.
Early enteral nutrition in dogs with critical illnesses, including septic peritonitis, has been shown to have a positive influence on patient outcome. Surgical placement of a gastrostomy tube (GT) is one option for providing early enteral nutrition. Complications, including premature tube removal or separation of the stomach from the body wall, can result in leakage of gastric contents into the abdominal cavity and subsequent peritonitis. A safe and reliable technique for the placement of a GT is desirable to minimize such complications.
A modified method for surgical placement of a GT is described. A thoracic trocar catheter (TTC) with an attached Pezzer tube is inserted through a gastrotomy incision and exited through the left gastric body and body wall. A left-sided tube gastropexy is performed using an interlocking box (ILB) pattern.
GT placement using a TTC is efficient, requiring minimal additional anesthesia time. The gastric defect created by the TTC conforms well with the Pezzer tube. As such, placement and utilization of the ILB suture pattern enables removal of the GT in the early postoperative period, if appropriate.
对于患有包括脓毒性腹膜炎在内的危重病犬,早期肠内营养已被证明对患者预后有积极影响。手术放置胃造口管(GT)是提供早期肠内营养的一种选择。并发症,包括胃造口管过早拔除或胃与体壁分离,可导致胃内容物漏入腹腔并继发腹膜炎。需要一种安全可靠的胃造口管放置技术,以尽量减少此类并发症。
描述了一种改良的胃造口管手术放置方法。将带有佩泽管的胸套管针导管(TTC)通过胃切开术切口插入,并从胃体左侧和体壁穿出。使用互锁盒(ILB)模式进行左侧胃固定术。
使用TTC放置GT效率高,所需额外麻醉时间最少。TTC造成的胃缺损与佩泽管贴合良好。因此,如果合适,ILB缝合模式的放置和使用能够在术后早期拔除GT。