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腹腔镜隐睾复位固定术在仰卧位马驹中的应用。

Laparoscopic cryptorchidectomy using a resorbable self-locking loop device in dorsally recumbent horses.

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, University of Montreal, Saint Hyacinthe, Quebec, Canada.

Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.

出版信息

Vet Surg. 2024 Feb;53(2):357-366. doi: 10.1111/vsu.14001. Epub 2023 Jul 18.

Abstract

OBJECTIVE

To report the use and feasibility of a self-locking resorbable loop device for cryptorchidectomy.

STUDY DESIGN

Clinical prospective study.

POPULATION

Twenty horses.

METHODS

Horses suspected to have an abdominal testicle/s after admission work-up were enrolled. Horses were anesthetized in dorsal recumbency and a standard laparoscopic technique was performed. The looped device was inserted into the abdomen, glided around the testis/cord and tightened. Then, the spermatic cord was transected prior testis removal. Surgical procedure details and remarks, perioperative complications and total surgical time were recorded. Short- (>3 weeks) and long-term (>6 months) follow-ups were obtained by telephone questionnaire.

RESULTS

Median total surgical time was 67 min (range: 43-189 min) and significantly shortened after the first four horses. The loop device was easily glided around 13/20 abdominal testes and required more time and technical skills around larger testes (≥3 years). Excellent intraoperative hemostasis was achieved in 17 horses. Three horses demonstrated mild intraoperative bleeding that required retightening, device replacement or adding a second device, respectively. Three horses developed mild postoperative hemoabdomen identified ultrasonographically and were successfully managed medically. Follow-up revealed no significant complications related to the procedure. One horse was euthanized for colic 4 months after surgery and one died of hemolytic shock 17 months postoperatively.

CONCLUSION

This device represents another method to perform equine cryptorchidectomy that requires minimal training and laparoscopic expertise but demands knowledge of the device and application to prevent complications.

CLINICAL SIGNIFICANCE

Laparoscopic cryptorchidectomy using this device is an alternative technique for horses <3 years.

摘要

目的

报告使用自锁可吸收环装置进行隐睾切除术的情况和可行性。

研究设计

临床前瞻性研究。

群体

20 匹马。

方法

对入院后疑似有腹侧隐睾/隐睾的马匹进行研究。马匹仰卧麻醉,采用标准腹腔镜技术。将环套装置插入腹部,在睾丸/精索周围滑动并收紧。然后,在切除睾丸之前切断精索。记录手术过程的详细信息和说明、围手术期并发症和总手术时间。通过电话问卷调查获得短期(<3 周)和长期(>6 个月)随访。

结果

中位总手术时间为 67 分钟(范围:43-189 分钟),前 4 匹马后明显缩短。环套装置在 13/20 例腹侧隐睾周围很容易滑动,但在更大的睾丸(≥3 岁)周围需要更多的时间和技术技能。17 匹马术中止血效果良好。3 匹马术中轻度出血,需要重新收紧、更换装置或添加第二个装置。3 匹马术后轻度出现超声检查证实的血腹,经药物治疗成功处理。随访未发现与手术相关的重大并发症。1 匹马术后 4 个月因腹痛而安乐死,1 匹马术后 17 个月因溶血性休克而死亡。

结论

该装置是另一种用于马属动物隐睾切除术的方法,需要的培训和腹腔镜专业知识最少,但需要了解该装置及其应用,以预防并发症。

临床意义

使用该装置进行腹腔镜隐睾切除术是一种替代技术,适用于<3 岁的马匹。

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