Complications and short-term outcomes associated with single-port laparoscopic splenectomy in dogs.

Autor: Mayhew PD; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California., Sutton JS; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California., Singh A; Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada., Runge JJ; Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania, Philadelphia, Pennsylvania., Case JB; Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida., Griffin MA; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California., Giuffrida MA; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Jazyk: angličtina
Zdroj: Veterinary surgery : VS [Vet Surg] 2018 Jun; Vol. 47 (S1), pp. O67-O74. Date of Electronic Publication: 2017 Nov 27.
DOI: 10.1111/vsu.12752
Abstrakt: Objective: To describe a technique and report complications and outcome for single-port laparoscopic splenectomy in dogs.
Study Design: Retrospective study.
Animals: Twenty-two client-owned dogs.
Methods: Medical records of dogs that underwent single-port laparoscopic splenectomy at 4 veterinary teaching hospitals were evaluated. Commercially available single-port devices were used in all dogs. In all cases, a vessel-sealing device was used to perform a hilar splenectomy. After the procedure was completed, the spleen was exteriorized through the single-port device incision or placed into a specimen retrieval device; enlargement of the incision was required in some cases.
Results: Median weight of dogs was 9.9 kg (interquartile range [IQR], 7.0-26.0). Splenectomy was performed because of splenic mass (n = 14), diffuse splenic disease (n = 4), or as adjunctive treatment for management of immune-mediated disease (n = 4). In cases with splenic masses, median maximal diameter of the largest splenic mass was 2.0 cm (IQR, 1.3-2.5). In 6 of 22 cases, mild splenic capsular bleeding occurred during the procedure. Conversion occurred in 6 of 22 cases to either a laparoscopic-assisted approach (n = 5) or an open celiotomy (n = 1). Reasons for conversion included large splenic dimensions (n = 3), adhesion formation (n = 1) or poor visualization resulting from abundant intra-abdominal fat (n = 1) or hemorrhage (n = 1). Heavier body weight was significantly associated with conversion (odds ratio, 1.62; 95% confidence interval, 1.05-2.51), but body condition score, having a splenic mass, splenic mass size, and surgical time were not.
Conclusion: Single-port laparoscopic splenectomy is an effective approach for elective splenectomy in dogs. The technique may be well suited to smaller dogs with modestly sized splenic masses or diffuse splenic disease.
(© 2017 The American College of Veterinary Surgeons.)
Databáze: MEDLINE
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