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腹腔镜辅助脾切除术相关的并发症和结果。

Complications and outcomes associated with laparoscopic-assisted splenectomy in dogs.

机构信息

1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada.

2Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.

出版信息

J Am Vet Med Assoc. 2022 Apr 27;260(11):1309-1315. doi: 10.2460/javma.21.12.0536.

Abstract

OBJECTIVE

To report the perioperative characteristics and outcomes of dogs undergoing laparoscopic-assisted splenectomy (LAS).

ANIMALS

136 client-owned dogs.

PROCEDURES

Multicentric retrospective study. Medical records of dogs undergoing LAS for treatment of naturally occurring splenic disease from January 1, 2014, to July 31, 2020, were reviewed. History, signalment, physical examination and preoperative diagnostic test results, procedural information, complications, duration of hospitalization, histopathologic diagnosis, and perioperative outcomes were recorded. Perioperative complications were defined using the Veterinary Cooperative Oncology Group - Common Terminology Criteria for Adverse Events (VCOG-CTCAE v2) guidelines.

RESULTS

LAS was performed for treatment of a splenic mass (124/136 [91%]), immune-mediated disease (7/136 [5%]), splenomegaly (4/136 [3%]), or immune-mediated disease in conjunction with a splenic mass (1/136 [1%]). Median splenic mass size was 1.3 cm3/kg body weight. Conversion to open laparotomy occurred in 5.9% (8/136) of dogs. Complications occurred in 78 dogs, with all being grade 2 or lower. Median surgical time was 47 minutes, and median postoperative hospital stay was 28 hours. All but 1 dog survived to discharge, the exception being postoperative death due to a suspected portal vein thrombus.

CLINICAL RELEVANCE

In the dogs of this report, LAS was associated with low rates of major complications, morbidity, and mortality when performed for a variety of splenic pathologies. Minimally invasive surgeons can consider the LAS technique to perform total splenectomy in dogs without hemoabdomen and with spleens with modest-sized splenic masses up to 55.2 cm3/kg, with minimal rates of complications, morbidity, and mortality.

摘要

目的

报告腹腔镜辅助脾切除术(LAS)中犬的围手术期特点和结果。

动物

136 只患犬。

程序

多中心回顾性研究。回顾 2014 年 1 月 1 日至 2020 年 7 月 31 日期间因自发性脾脏疾病接受 LAS 治疗的犬的病历。记录病史、品种、体格检查和术前诊断检查结果、手术信息、并发症、住院时间、组织病理学诊断和围手术期结果。根据兽医合作肿瘤学组-常见不良事件术语标准(VCOG-CTCAE v2),将围手术期并发症定义为 1 级和 2 级。

结果

LAS 用于治疗脾脏肿块(124/136 [91%])、免疫介导性疾病(7/136 [5%])、脾肿大(4/136 [3%])或免疫介导性疾病合并脾脏肿块(1/136 [1%])。脾脏肿块的中位数大小为 1.3 cm3/kg 体重。5.9%(8/136)的犬中转开腹手术。78 只犬发生并发症,均为 2 级或更低。中位手术时间为 47 分钟,中位术后住院时间为 28 小时。除 1 只犬因疑似门静脉血栓形成术后死亡外,所有犬均存活至出院。

临床相关性

在本报告的犬中,LAS 用于治疗各种脾脏疾病时,严重并发症、发病率和死亡率均较低。微创外科医生可以考虑 LAS 技术对无血腹和脾脏肿块最大为 55.2 cm3/kg 的犬进行全脾切除术,并发症、发病率和死亡率均较低。

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