Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany.
Am J Vet Res. 2024 Apr 19;85(7). doi: 10.2460/ajvr.23.12.0286. Print 2024 Jul 1.
To assess the histological injury and intestinal microperfusion measured by laser Doppler flowmetry and spectrophotometry (LDFS) of the small intestine orad to a strangulation during colic surgery.
Horses with naturally occurring small intestinal strangulations undergoing colic surgery were included.
In this prospective clinical trial, intestinal tissue oxygen saturation (tSO2) and tissue blood flow (tBF) were measured by LDFS orad to the strangulation following release of the strangulation (n = 18). The number of horses with postoperative reflux (POR) and the cases that survived until discharge were compared between groups using Fisher's exact test (P < .05). Intestinal biopsies were taken in cases that underwent intestinal resection or intraoperative euthanasia (n = 28). Measurements were compared between injured and noninjured segments with a Mann-Whitney U or t test.
The tSO2 and tBF of the orad intestine were lower than previously reported in healthy horses. Horses with low tSO2 of < 35% were significantly more likely to suffer from POR (6/6 cases) compared to cases with tSO2 > 69% (1/6). The number of horses that survived were not statistically different between these groups (2/6 and 6/6). All horses with mucosal injury developed POR (6/6), which was significantly more likely compared to horses without mucosal injury (3/13). No significant difference in tSO2 or tBF could be found between the segments with and without histological injury.
The results suggest that measuring tSO2 in the orad segment during colic surgery may aid in predicting postoperative issues.
评估在结肠手术过程中发生绞窄性肠梗时，使用激光多普勒流量测定法（LDFS）和分光光度法（LDFS）测量的小肠近侧组织学损伤和肠微灌注。
纳入自然发生小肠绞窄性肠梗阻并接受结肠手术的马。
在这项前瞻性临床试验中，在释放绞窄后（n = 18），通过 LDFS 测量近侧肠组织氧饱和度（tSO2）和组织血流（tBF）。使用 Fisher 确切检验（P <.05）比较术后反流（POR）和存活至出院的马匹数量在组间的差异。对接受肠切除术或术中安乐死的病例（n = 28）进行肠活检。使用 Mann-Whitney U 或 t 检验比较损伤和未损伤节段之间的测量值。
近侧肠的 tSO2 和 tBF 低于健康马的先前报道。tSO2 < 35%的马发生 POR（6/6 例）的可能性明显高于 tSO2 > 69%的马（1/6）。这些组之间存活的马匹数量没有统计学差异（2/6 和 6/6）。所有有黏膜损伤的马都发生了 POR（6/6），这明显比没有黏膜损伤的马（3/13）更常见。在有和没有组织学损伤的节段之间，tSO2 或 tBF 没有显著差异。
结果表明，在结肠手术过程中测量近侧段的 tSO2 可能有助于预测术后问题。
