Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Department of Biostatistics and Medical Informatics, University of Wisconsin - Madison, Madison, Wisconsin, USA.
Vet Surg. 2022 Aug;51(6):920-928. doi: 10.1111/vsu.13838. Epub 2022 Jun 13.
To describe the paracostal approach to caudate liver lobectomy in rabbits and compare the outcome of paracostal versus ventral midline approach for caudate liver lobectomy in rabbits with caudate liver lobe torsion (LLT).
Cadaveric and retrospective study.
Normal rabbit cadavers (n = 5) and rabbits with caudate LLT (n = 22).
Cadavers - a right paracostal or ventral midline approach was made. Accessibility of the caudate liver lobe and relationship to the gastrointestinal (GI) tract were assessed. Clinical LLT cases - 9 cases were treated via the paracostal approach and 13 were treated via the ventral midline approach. Medical records (January, 2018 to October, 2021) were reviewed. Anesthesia and surgical times, mortality rate, and relevant clinical data were compared between groups.
In cadavers, caudate liver lobectomy was feasible through a paracostal approach without retraction of the GI tract. In clinical cases, there was no difference in anesthesia time (P = 0.1397) or surgical time (P = 0.9462) between groups. All rabbits that underwent paracostal approach survived to discharge. Mortality was lower (P = .053) and postoperative time until eating was shorter (P = .0238) for patients undergoing paracostal approach.
Rabbits experienced lower mortality and shorter time until eating when treated through a right paracostal approach compared to the ventral midline approach. The paracostal approach resulted in minimal to no manipulation of the GI tract.
A right paracostal approach for caudate liver lobectomy in rabbits provides good exposure while avoiding GI tract manipulation. This approach may result in improved survival and earlier eating in rabbits with caudate LLT.
描述兔肝尾叶经肋缘下入路肝切除术，并比较肋缘下入路与腹正中入路在兔肝尾叶扭转（LLT）时行肝尾叶切除术的结果。
尸体研究和回顾性研究。
正常兔尸体（n=5）和兔肝尾叶扭转（n=22）。
尸体研究——采用右肋缘下入路或腹正中入路。评估肝尾叶的可及性及其与胃肠道（GI）的关系。临床 LLT 病例——9 例采用肋缘下入路治疗，13 例采用腹正中入路治疗。回顾性分析 2018 年 1 月至 2021 年 10 月的病历。比较两组的麻醉时间和手术时间、死亡率和相关临床资料。
在尸体中，无需牵拉 GI 即可通过肋缘下入路行肝尾叶切除术。在临床病例中，两组的麻醉时间（P=0.1397）或手术时间（P=0.9462）无差异。所有接受肋缘下入路治疗的兔均存活至出院。接受肋缘下入路治疗的死亡率较低（P=0.053），术后开始进食的时间较短（P=0.0238）。
与腹正中入路相比，右侧肋缘下入路治疗兔肝尾叶扭转时死亡率较低，开始进食时间较短。肋缘下入路对胃肠道的操作最小化。
兔肝尾叶切除术采用右侧肋缘下入路可提供良好的显露，同时避免对胃肠道的操作。这种方法可能会提高兔肝尾叶扭转时的存活率和更早开始进食。
