Sunghan Jutapoln, Manmoo Sareepah, Suriyasathaporn Wanna, Suriyasathaporn Witaya, Warrit Kanawee, Kusolphat Pradipa
Faculty of Veterinary Science, Prince of Songkla University, Hat Yai, 90110, Thailand.
Department of Companion Animal and Wildlife Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand.
Vet World. 2023 Feb;16(2):386-394. doi: 10.14202/vetworld.2023.386-394. Epub 2023 Feb 28.
Vessel sealing (VS) is used widely in human medicine and veterinary practice during laparoscopic surgery; however, few studies have investigated VS in canine ovariohysterectomy (OHE) using the median celiotomy approach. This study aimed to compare the effect of VS and suture ligation (SL) on surgical time, blood loss, and perioperative pain in canine OHE through median celiotomy.
Twenty-eight dogs were randomly and equally assigned into two groups that underwent surgery either by SL at both the ovarian pedicle and uterus or using a disposable VS device. The short form of the Glasgow composite pain scale (SF-GCPS) and the Colorado state university canine acute pain scale (CSU-CAP) were used to determine pain pre-operatively (baseline); at 30 min; and at 1, 2, 3, 4, 24, and 72 h post-operatively. Perioperative physiological parameters, surgical duration, and percentage of blood loss were recorded. Repeated measures analysis was performed to determine the differences in all parameters among time-related tasks and between both groups. A significant difference was defined at p < 0.05.
The duration from identification of the first ovary to uterus removal was shorter in VS than in SL (p < 0.05). No clinically relevant differences were found among physiological variables. Both groups showed higher SF-GCPS and CSU-CAP values after surgery compared with baseline. The SF-GCPS in SL at 1 h was higher than in VS (p < 0.05). Two dogs in the SL group required additional post-operative rescue analgesia. No differences were found between the groups in terms of blood loss.
The use of a VS device in dogs undergoing OHE celiotomy decreased post-operative pain and shortened the perioperative time, making it an effective alternative technique for this common surgery. However, the VS device must be applied 2-3 times in the same location during the OHE procedure to prevent technical failure. This disposable device was reused up to 5 times for economic reasons without device failure. Soft tissue damage during OHE using the VS device should be investigated in a future prospective study.
血管闭合（VS）在人类医学和兽医腹腔镜手术中广泛应用；然而，很少有研究通过正中剖腹术探讨犬卵巢子宫切除术（OHE）中VS的应用。本研究旨在比较VS和缝合结扎（SL）在犬OHE正中剖腹术中对手术时间、失血量和围手术期疼痛的影响。
28只犬被随机均分为两组，分别采用卵巢蒂和子宫的SL或一次性VS设备进行手术。采用格拉斯哥综合疼痛量表简表（SF-GCPS）和科罗拉多州立大学犬急性疼痛量表（CSU-CAP）在术前（基线）、术后30分钟以及术后1、2、3、4、24和72小时测定疼痛程度。记录围手术期生理参数、手术持续时间和失血量百分比。采用重复测量分析确定时间相关任务及两组之间所有参数的差异。以p<0.05定义为显著差异。
VS组从识别第一个卵巢到切除子宫的时间比SL组短（p<0.05）。生理变量之间未发现临床相关差异。与基线相比，两组术后的SF-GCPS和CSU-CAP值均更高。SL组术后1小时的SF-GCPS高于VS组（p<0.05）。SL组有2只犬术后需要额外的急救镇痛。两组间失血量无差异。
在接受OHE剖腹术的犬中使用VS设备可减轻术后疼痛并缩短围手术期时间，使其成为这种常见手术的有效替代技术。然而，在OHE手术过程中，VS设备必须在同一位置应用2-3次以防止技术故障。出于经济原因，该一次性设备可重复使用多达5次且无设备故障。未来的前瞻性研究应调查使用VS设备进行OHE时的软组织损伤情况。
