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比较四年级兽医学生用双结扎和自动结扎猫卵巢蒂引起的出血并发症。

Comparison of Hemorrhagic Complications with Double-ligated versus Auto-ligated Feline Ovarian Pedicles by Fourth-Year Veterinary Students.

出版信息

J Vet Med Educ. 2021 Dec;48(6):679-685. doi: 10.3138/jvme-2020-0011. Epub 2020 Nov 21.

Abstract

The objective of this article is to compare the occurrence of hemorrhagic complications in student-performed feline ovarian pedicle ligations using the traditional suture pedicle double-ligation (PDL) to the suture-less auto-ligation (AL) techniques, and to describe the stepwise method of teaching the AL technique to students. A total of 287 cats underwent an ovariohysterectomy (OHE) performed by a fourth-year veterinary student trained by veterinary faculty to perform the AL technique beginning with a low-fidelity model and progressing to live patient surgeries. Students performed the AL and PDL techniques on 146 and 141 cats respectively. Hemorrhagic complications occurred in 4 of 146 cats (2.7%) in the AL group and 8 of 141 (5.7%) in the PDL group and were not found to be significantly different ( = 0.2496). This article demonstrates that novice surgeons can safely perform the AL technique on feline ovarian pedicles without significantly increasing complications compared to the traditionally taught method when a stepwise training program is implemented. Additionally, this technique has been shown to be safe, effective, and more efficient when performed by experienced veterinary surgeons. Veterinary institutions should consider including the AL technique in their core curricula as a standard method for feline ovarian pedicle ligation. Doing so will facilitate the development of more proficient entry-level practitioners who are better able to serve their patients, clients, employers, humane societies, and their communities by using a more efficient and safe feline ovariohysterectomy technique.

摘要

本文旨在比较使用传统缝线结扎(PDL)和无缝线自动结扎(AL)技术对学生进行的猫卵巢蒂结扎时出血并发症的发生情况,并描述向学生传授 AL 技术的分步方法。共有 287 只猫接受了第四年兽医学生进行的卵巢子宫切除术(OHE),这些学生在兽医教员的指导下,从低保真模型开始,逐步过渡到活体患者手术,接受了 AL 技术的培训。学生们分别对 146 只猫和 141 只猫进行了 AL 和 PDL 技术操作。AL 组的 4 只(2.7%)和 PDL 组的 8 只(5.7%)猫出现了出血并发症,但差异无统计学意义( = 0.2496)。本文表明,当实施分步培训计划时,与传统教学方法相比,新手外科医生可以安全地对猫卵巢蒂进行 AL 技术操作,而不会显著增加并发症。此外,当由经验丰富的兽医外科医生进行时,该技术已被证明是安全、有效且更高效的。兽医机构应考虑将 AL 技术纳入其核心课程,作为猫卵巢蒂结扎的标准方法。这样做将有助于培养更熟练的入门级从业者,使他们能够通过使用更高效和安全的猫卵巢子宫切除术技术更好地为患者、客户、雇主、动物保护协会及其社区服务。

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