不切除卵巢的站立位下腹腔镜结扎母马系膜的疗效

A. Rijkenhuizen, F. Jonker, G. Grinwis
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引用次数: 1

摘要

前瞻性对照研究与结扎精索腹隐睾马腹腔镜入路结果功能性阉割。为了研究系膜结扎对5匹3 - 16岁、卵巢正常的母马(1匹荷兰温血马和4匹威尔士马)卵巢功能活力的影响,采用站立位腹腔镜技术在腹腔内结扎系膜,包括卵巢动脉和静脉。卵巢被留在原位。术后测量雌激素和孕激素水平。5匹母马分别于术后第14天、第28天和第5个月进行双侧腹腔镜检查,随后对母马实施安乐死。进行尸检,并对卵巢和子宫进行了宏观和组织学检查。此外,在征得患者知情同意的情况下,对4名患者进行了相同的腹腔镜手术。结果9匹母马中有7匹术后平均雌激素、孕激素水平较低。在不切除卵巢的情况下,两步结扎卵巢的手术在18个卵巢中有15个(83%)成功。总之,通过结扎对母马进行阉割,不切除卵巢,通过腹腔镜干预是可能的。卵巢手术技术是安全的,是一种以微创方式对站立患者进行阉割的方法。然而,9匹母马中只有6匹(67%)被有效阉割。失败可能是由于技术原因,需要进一步修改应用程序以提高成功率。母马数量少限制了研究的意义。
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Efficacy of laparoscopic ligation of the mesovarium of the mare in the standing position without removal of the ovary
The prospective controlled study with the ligation of the spermatic cord in abdominal cryptorchid horses by laparoscopic approach results in a functional castration. To examine the effect of ligation of the mesovarium on the functional viability of the ovary in five mares (one Dutch Warmblood and 4 Welsh ponies), from 3 to 16 years of age, with normal ovaries, the mesovarium, including the ovarian artery and vein, was ligated intra-abdominally using a laparoscopic technique in the standing position. The ovaries were left in place. Post-operative estrogen and progesterone levels were measured. Bilateral relaparoscopy was performed on day 14, day 28 and 5 months after the initial surgery in all 5 mares and the mares were subsequently euthanized. Autopsy was performed and the ovaries and uterus were examined macroscopically and histologically. Additionally, the same laparoscopic procedure was performed on 4 patients with informed consent of the owners. In result the mean oestrogen and progesterone level of 7 out of 9 mares were low after surgery. The procedure of a two-step ligation of the ovary, with out removing the ovary, was successful in 15 out of the 18 ovaries (83 %). In conclusion the castration of mares by ligation, without removal of the ovaries, by laparoscopic intervention is possible. The surgical technique for devitalisation of the ovaries is safe and represents a method of castrating in the standing patient in a minimal invasive way. However, the procedure resulted in effective castration only in 6 of the 9 mares (67 %). The failure was probably technique-based and further modification of the applied procedure is necessary to improve the success rate. The low number of mares limitates the significance of the study.
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