Publicação
Recurrent nephrosplenic entrapment : a review of cases, shorterm and longterm outcome after laparoscopic nephrosplenic space closure with barbed knotless suture in horses
| Resumo: | Left colon displacement and nephrosplenic space entrapment (NSE) is a pathology affecting 6-20,3% of horses suffering from colic and has a reported recurrence of 8-23%. Therefore owners of horses having this type of colic should be warned about its recurrence and advised to perform preventive procedures. Among all the procedures available the one showing better prognosis relies on the closure of the nephrosplenic space. This can be performed through a flank laparotomy, though laparoscopic procedures are nowadays widely used. When entrapment is present by the time of closure most authors describe the need of converting into a hand assisted procedure or deviation of the colon with the aid of instruments. The aim of this study was to present a novel technique, were dorsal abdominal insufflation plays a key role in deviating the entrapped colon and allowing good visualization and closure of the nephrosplenic space. We aimed to assess the short and long term outcomes for horses undergoing this procedure. Data from 28 horses who underwent nephrosplenic space closure with barbed knotless suture were collected. Short term follow up was achieved by rectal palpation 15 days post-surgery and long term follow up was achieved by telephone questionnaire to the owners. Results from horses with NSE at the time of surgery were compared with those where the colon was not entrapped at the beginning of surgery. Total number of episodes of NSE before surgery and number of colic episodes (and diagnosis) after surgery were registered. No differences were found regarding time of surgery and time of closure of the space which suggests there is no increased difficulties or complications when NSE is present by the time of surgery. Adherence of the displaced colon was feared in horses with NSE at time of surgery but short term and long term outcome was positive in every horse. None of the horses had recurrence of NSE after the surgery. Some horses had other colic episodes after the surgery but all were not related to NSE or the surgery itself. As so, these results indicate this procedure to be a time saving and safe technique to perform when the colon is displaced, therefore increasing the advantages of this minimally invasive procedure. |
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| Autores principais: | Dias, Ana Beatriz Mourato |
| Assunto: | Horses Surgery Nephrosplenic Space Entrapment Nephrosplenic Space Closure Barbed Suture Cavalos Cirurgia Encarceramento do Espaço Nefrosplénico Encerramento do Espaço Nefrosplénico Sutura Barbada |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Left colon displacement and nephrosplenic space entrapment (NSE) is a pathology affecting 6-20,3% of horses suffering from colic and has a reported recurrence of 8-23%. Therefore owners of horses having this type of colic should be warned about its recurrence and advised to perform preventive procedures. Among all the procedures available the one showing better prognosis relies on the closure of the nephrosplenic space. This can be performed through a flank laparotomy, though laparoscopic procedures are nowadays widely used. When entrapment is present by the time of closure most authors describe the need of converting into a hand assisted procedure or deviation of the colon with the aid of instruments. The aim of this study was to present a novel technique, were dorsal abdominal insufflation plays a key role in deviating the entrapped colon and allowing good visualization and closure of the nephrosplenic space. We aimed to assess the short and long term outcomes for horses undergoing this procedure. Data from 28 horses who underwent nephrosplenic space closure with barbed knotless suture were collected. Short term follow up was achieved by rectal palpation 15 days post-surgery and long term follow up was achieved by telephone questionnaire to the owners. Results from horses with NSE at the time of surgery were compared with those where the colon was not entrapped at the beginning of surgery. Total number of episodes of NSE before surgery and number of colic episodes (and diagnosis) after surgery were registered. No differences were found regarding time of surgery and time of closure of the space which suggests there is no increased difficulties or complications when NSE is present by the time of surgery. Adherence of the displaced colon was feared in horses with NSE at time of surgery but short term and long term outcome was positive in every horse. None of the horses had recurrence of NSE after the surgery. Some horses had other colic episodes after the surgery but all were not related to NSE or the surgery itself. As so, these results indicate this procedure to be a time saving and safe technique to perform when the colon is displaced, therefore increasing the advantages of this minimally invasive procedure. |
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