RESUMO
OBJECTIVE: To determine the influence of the staple line configuration on the leakage of small intestinal functional end-to-end stapled anastomosis (FEESA). STUDY DESIGN: Experimental, ex vivo, randomized study. SAMPLE POPULATION: Jejunal segments (N = 72) from 10 mature, canine cadavers. METHODS: Jejunal segments (10 cm) were randomly assigned to a control group (8 segments) and 4 FEESA groups (16 segments/group (8 constructs/group)), according to the number of rows of staples used in the vertical (V) and transverse lines (T), respectively: Control, 2-row V/2-row T (2V/2T), 2-row V/3-row T (2V/3T), 3-row V/2-row T (3V/2T), 3-row V/3-row T (3V/3T). Initial leak pressure (ILP), maximum intraluminal pressure (MIP), and initial leakage location (ILL) were compared. RESULTS: The ILP (mean ± SD) for control segments, 2V/2T, 2V/3T, 3V/2T and 3V/3T were 321.38 ± 34.59, 32.88 ± 7.36, 50.13 ± 10.46, 34.38 ± 11.78, 69.88 ± 21.23 mmHg, respectively. All FEESAs initially leaked at lower pressures than intact segments. The only other differences detected between groups consisted of ILPs that were higher when FEESAs were closed with 3V/3T (69.88 ± 21.23 mmHg) than 2V/2T (32.88 ± 7.36, P < .001). Initial leakage occurred predominantly from the transverse staple line rather than the anastomotic crotch (P < .001). CONCLUSION: Placing 3 rows of staples in the transverse line (with or without a third row in the vertical staple line) improved resistance to leakage of FEESAs in normal cadaveric specimens. CLINICAL SIGNIFICANCE: The addition of a third row of staples in the transverse line (with or without a third row in the vertical staple line) in FEESAs should be further investigated as a strategy to reduce intestinal leakage clinically.
Assuntos
Intestino Delgado , Suturas , Anastomose Cirúrgica/veterinária , Animais , Cães , Intestino Delgado/cirurgia , Pressão , Grampeamento Cirúrgico/veterináriaRESUMO
Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...(AU)
Assuntos
Animais , Feminino , Cães , Cães/anormalidades , Rádio (Anatomia)/anormalidades , Osteotomia/veterinária , Ulna , Grampeamento Cirúrgico/veterinária , Fixadores Externos/veterinária , Ortopedia/veterináriaRESUMO
Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...