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马小肠端端吻合三种技术的评估

Evaluation of three techniques for end-to end anastomosis of the small colon in horses.

作者信息

Hanson R R, Nixon A J, Calderwood-Mays M, Gronwall R

机构信息

Department of Surgical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610.

出版信息

Am J Vet Res. 1988 Sep;49(9):1613-20.

PMID:3223675
Abstract

In an attempt to determine the best method for surgical removal of devitalized small colon lesions, 12 horses underwent a double small colon resection and end-to-end anastomosis. In 4 horses (study 1), an appositional single-layer (APP-1) suture pattern was compared with an inverting 2-layer (INV-2) suture pattern. In 8 horses (study 2), an appositional 2-layer (APP-2) suture pattern was compared with the INV-2 suture technique. Polydioxanone suture (size 1-0), was used. Horses were evaluated at necropsy 3, 10, 14, 28, or 56 days after surgery. Postoperative complications (peritonitis, impaction, or excessive adhesions) were encountered in 100, 42, and 13% of the APP-1, INV-2, and APP-2 anastomoses, respectively. Postmortem evaluation of the small colon revealed dehiscence of the anastomotic site, diffuse peritonitis, and adhesion formation in 3 of the 4 horses in which the resection line was closed with the APP-1 pattern. With the INV-2 and APP-2 techniques, more intestinal inversion was present in the nontaenial than in the taenial portion of the small colon. More postoperative impactions were found with the INV-2 (n = 5) anastomoses than with the APP-2 (n = 1) technique; this appeared to be the result of excessive tissue inversion. There was no difference in lumen diameter between the INV-2 and the APP-2 techniques (P greater than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了确定手术切除失活的小结肠病变的最佳方法,12匹马接受了小结肠双段切除及端端吻合术。在4匹马中(研究1),将对合单层(APP-1)缝合方式与内翻双层(INV-2)缝合方式进行比较。在8匹马中(研究2),将对合双层(APP-2)缝合方式与INV-2缝合技术进行比较。使用聚二氧六环酮缝线(1-0号)。在术后3、10、14、28或56天对马进行尸检评估。APP-1、INV-2和APP-2吻合口术后并发症(腹膜炎、肠阻塞或粘连过多)的发生率分别为100%、42%和13%。对小结肠的尸检评估显示,在采用APP-1方式闭合切除线的4匹马中,有3匹马出现吻合口裂开、弥漫性腹膜炎和粘连形成。采用INV-2和APP-2技术时,小结肠无系膜部分比有系膜部分出现更多的肠管内翻。INV-2吻合术(n = 5)比APP-2技术(n = 1)出现更多的术后肠阻塞;这似乎是组织过度内翻的结果。INV-2和APP-2技术之间的管腔直径无差异(P≥0.05)。(摘要截断于250字)

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