Bertone A L, Stashak T S, Sullins K E, Ralston S L
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523.
Vet Surg. 1987 Jan-Feb;16(1):5-12. doi: 10.1111/j.1532-950x.1987.tb00906.x.
Ten normal horses had approximately 95% of the length of the large colon resected with a side-to-side anastomosis between right ventral and right dorsal colon performed with surgical stapling equipment. Four horses died shortly after surgery of colitis (1 horse) or failure of the TA 90 transection staple line (3 horses). Another horse died 4 months after surgery from disseminated streptococcal infection but had recovered well from the colon resection. Five horses survived long term (18 months) with no clinical evidence of adverse effects of the resection. Surviving horses had weight loss and soft fecal consistency for 3 to 12 weeks after surgery but returned to preoperative values within 12 months. At a second surgery 1 year later (5 horses) or at necropsy 4 months later (1 horse), fibrous omental adhesions were present over the transection staple line in four horses and over the anastomotic staple line in two horses. Omental adhesions to the everted staple line were moderate but not associated with any clinical sequellae. An incisional hernia was present in one horse. The anastomotic stomata measured between 8 and 9 cm, which was 60% of the size of the original surgically created stomata. Failure of the transection staple line occurred in the first three of five horses in which the procedure was attempted due to improper configuration of the staples or crushing of the tissue between the staples. Experience corrected this complication.
十匹正常马的大结肠约95%的长度被切除,使用手术吻合器械在右腹侧结肠和右背侧结肠之间进行侧侧吻合。四匹马在术后不久因结肠炎(1匹马)或TA 90切割吻合钉线失败(3匹马)死亡。另一匹马在术后4个月死于播散性链球菌感染,但结肠切除术后恢复良好。五匹马长期存活(18个月),没有切除产生不良反应的临床证据。存活的马在术后3至12周体重减轻且粪便质地变软,但在12个月内恢复到术前水平。在1年后的第二次手术(5匹马)或4个月后的尸检(1匹马)中,四匹马的切割吻合钉线上有纤维性网膜粘连,两匹马的吻合吻合钉线上有纤维性网膜粘连。网膜与外翻吻合钉线的粘连程度中等,但未伴有任何临床后遗症。一匹马出现切口疝。吻合口气孔大小在8至9厘米之间,为最初手术造口大小的60%。在尝试该手术的五匹马中的前三匹马中,由于吻合钉配置不当或吻合钉之间的组织受压,切割吻合钉线失败。经验纠正了这一并发症。