Sellier Clément, Carabalona Julien, Hahn Harriet, Dvm Eymeric Gomes, Bismuth Camille
Department of Surgery, Small Animal, Veterinary Hospital Frégis, Arcueil, France.
Department of Diagnostic Imaging, Small Animal, Veterinary Hospital Frégis, Arcueil, France.
Vet Surg. 2020 May;49(4):800-810. doi: 10.1111/vsu.13401. Epub 2020 Feb 19.
To report the clinical use of a cavitron ultrasonic surgical aspirator (CUSA) for the resection of hepatic lesions in dogs.
Clinical prospective study.
Eleven client-owned dogs.
Dogs requiring a hepatic nodulectomy, segmentectomy, and/or a lobectomy (including complex lobectomies) were enrolled. The number and location of procedures, blood loss, duration of surgery, and short-term complications were recorded.
Dogs underwent a mean of 2.3 ± 1.1 procedures. All masses were amenable to surgical excision regardless of their location and their relationship with major hepatic vessels. Dogs lost a median of 77 mL of blood (9.9-161), which corresponded to 4.3% of blood volume (0.8%-23.2%). The dog with the highest blood loss survived without requiring transfusion. The median duration of all CUSA procedures was 33.5 minutes (15-82). Short-term outcomes were assessed for the first 15 days, during which two complications were diagnosed. Cholangiohepatitis was diagnosed in one dog and resolved after medical management, and another dog developed necrotic pancreatitis and died.
Liver parenchyma-sparing nodulectomies and segmentectomies and liver lobectomies including complex lobectomies were achieved with a CUSA in all dogs.
Use of a CUSA can be considered as an alternative for the removal of hepatic lesions in dogs.
报告超声外科吸引器(CUSA)在犬肝脏病变切除术中的临床应用。
临床前瞻性研究。
11只客户拥有的犬。
纳入需要进行肝结节切除、肝段切除和/或肝叶切除(包括复杂肝叶切除)的犬。记录手术的数量和位置、失血量、手术持续时间和短期并发症。
犬平均接受2.3±1.1次手术。所有肿块无论其位置以及与主要肝血管的关系如何,均适合手术切除。犬的失血量中位数为77 mL(9.9 - 161),相当于血容量的4.3%(0.8% - 23.2%)。失血量最多的犬存活下来,无需输血。所有CUSA手术的中位数持续时间为33.5分钟(15 - 82)。在前15天评估短期结果,在此期间诊断出2例并发症。1只犬被诊断为胆管肝炎,经药物治疗后痊愈,另1只犬发生坏死性胰腺炎并死亡。
所有犬均通过CUSA成功实施了保留肝实质的结节切除、肝段切除以及包括复杂肝叶切除在内的肝叶切除。
CUSA可被视为犬肝脏病变切除的一种替代方法。