犬肝小叶切除术用血管盒吻合器:13例回顾性研究。

IF 1.1 4区 农林科学 Q3 VETERINARY SCIENCES New Zealand veterinary journal Pub Date : 2023-09-01 DOI:10.1080/00480169.2023.2212613
D Szwec, A Singh, M Gatineau
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引用次数: 0

摘要

病例史:回顾了加拿大两家兽医医院的医疗记录,以确定2016年1月至2018年6月期间使用带血管盒的Endo GIA外科吻合器(打开和关闭的钉钉高度分别为2.5和1.0 mm)通过开腹手术行肝叶切除术的犬的病例。纳入研究的狗(n = 13)手术时的平均年龄为10.4岁(SD 1.5;最小7.9岁,最大12.8岁,平均体重14公斤(最小3.9岁,最大37.8公斤)。临床表现:12只犬经腹部超声检查发现肝脏肿块,需行肝叶切除术。其余的狗需要切除右内侧肝叶,以解决右侧内侧肝管渗漏的问题,这是胆囊切除术治疗破裂的胆囊粘液囊肿的并发症。治疗和结果:使用Endo GIA装置通过开腹手术对12只狗进行了14叶(11叶来自左肝分区)的完全肝叶切除术和1只狗的部分肝叶切除术。平均手术时间,包括并发手术,为50 (SD 17;中位45分钟,最短28分钟,最长91分钟。术中并发症以肝实质渗出最为常见(6/13),均为轻度。5只狗出现了轻微的术后并发症。无重大围手术期或术后并发症发生,无患者需要再次手术探查。所有患者均存活至出院,并在2周的随访中存活。临床意义:使用带有血管盒的Endo GIA吻合器用于左肝段肝叶切除术是可行的,并且在本研究中术中和术后并发症发生率低。Endo GIA吻合器是这种类型的狗肝叶切除术的可行选择。虽然成功,但本研究中少量的中央(两个叶)和右侧(一个叶)肝分叶切除术使我们无法得出关于该技术在这些分叶上可行性的明确结论。
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Hepatic lobectomy in dogs using a stapling device with a vascular cartridge: a retrospective study of 13 cases.

Case history: Medical records of two veterinary hospitals in Canada were reviewed to identify cases of dogs that underwent liver lobectomy via open laparotomy using the Endo GIA surgical stapling device with a vascular cartridge (height of open and closed staples: 2.5 and 1.0 mm, respectively) between January 2016 and June 2018. Mean age at the time of surgery of the dogs (n = 13) included in the study was 10.4 (SD 1.5; min 7.9, max 12.8) years and mean body weight was 14 (min 3.9, max 37.8) kg.

Clinical findings: Liver masses requiring hepatic lobectomy were identified in 12 dogs by abdominal ultrasound examination. The remaining dog required a lobectomy of the right medial liver lobe to address leakage from the right medial lobe hepatic duct that occurred as a complication of cholecystectomy to treat a ruptured gallbladder mucocoele.

Treatment and outcome: Complete liver lobectomy of 14 lobes (11 from the left hepatic division) in 12 dogs and partial lobectomy of one lobe in one dog was performed via open laparotomy using the Endo GIA device. The mean surgical time, including concurrent procedures, was 50 (SD 17; median 45, min 28, max 91) minutes. The most common intra-operative complication was oozing from the transected liver parenchyma in 6/13 dogs, which was mild in all cases. Five dogs experienced minor post-operative complications. No major peri- or post-operative complications occurred, and no patients required surgical re-exploration. All patients survived until discharge and were alive at the 2-week follow-up for suture removal.

Clinical relevance: Use of the Endo GIA stapling device with a vascular cartridge is feasible for liver lobectomy of the left hepatic division and in this study had low rates of intra-operative and post-operative complications. The Endo GIA stapling device is a viable option for this type of liver lobectomy in dogs. Though successful, the small number of central (two lobes) and right (one lobe) hepatic division lobectomies in this study precludes us from drawing definitive conclusions about the feasibility of this technique on these divisions.

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来源期刊
New Zealand veterinary journal
New Zealand veterinary journal 农林科学-兽医学
CiteScore
3.00
自引率
0.00%
发文量
37
审稿时长
12-24 weeks
期刊介绍: The New Zealand Veterinary Journal (NZVJ) is an international journal publishing high quality peer-reviewed articles covering all aspects of veterinary science, including clinical practice, animal welfare and animal health. The NZVJ publishes original research findings, clinical communications (including novel case reports and case series), rapid communications, correspondence and review articles, originating from New Zealand and internationally. Topics should be relevant to, but not limited to, New Zealand veterinary and animal science communities, and include the disciplines of infectious disease, medicine, surgery and the health, management and welfare of production and companion animals, horses and New Zealand wildlife. All submissions are expected to meet the highest ethical and welfare standards, as detailed in the Journal’s instructions for authors.
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