Topic:Adhesions
Intra-abdominal adhesions in horses: a retrospective evaluation of repeat laparotomy in 99 horses with acute gastrointestinal disease. The objectives of this study were (1) to determine the prevalence of pathological abdominal adhesion formation following exploratory laparotomy; (2) to establish the site of adhesion formation and its relationship to the initial lesion; (3) to ascertain whether the development of intra-abdominal adhesions decreases long-term survival and (4) to identify risk factors for adhesion formation. Of 1014 horses treated surgically for acute gastrointestinal disease, 113 (10.1%) were subjected to repeat laparotomy, with surgical records available for 99 of these cases. Pathological adhesions were the m...
Cloning and functional characterization of recombinant equine P-selectin. The recent molecular characterization and sequencing of equine P-selectin (ePsel), and its glycoprotein ligand, P-selectin glycoprotein ligand-1 (PSGL-1), have provided the tools for further investigation into their role in leukocyte trafficking. Here, we report the generation of a genetically engineered chimeric protein (ePsel-IgG) in which the equine P-selectin lectin and epithelial growth factor (EGF) domains were covalently linked to the equine IgG1 heavy chain constant region. The soluble ePsel-IgG was observed to bind to equine monocytes by confocal microscopy and flow cytometry. Further...
Laparoscopic obliteration of the nephrosplenic space using polypropylene mesh in five horses. To report a laparoscopic technique for insertion of polypropylene mesh in the nephrosplenic space in horses and evaluate outcome. Methods: Descriptive experimental study. Methods: Five healthy mature horses. Methods: One laparoscope and 2 instrument portals were made on the left side of the horse. The nephrosplenic space was measured and appropriately sized polypropylene mesh was inserted and attached to the dorsolateral splenic capsule and perirenal fascia using helical titanium coils. All horses had repeat laparoscopy 4 weeks later and were necropsied at intervals 4-14 weeks after mesh place...
Laparoscopic ovariectomy in mares using a polyamide tie-rap. To describe use of a polyamide tie-rap to ligate the mesovarium during standing laparoscopic ovariectomy in mares. Methods: Prospective study. Methods: Ten mares. Methods: Bilateral ovariectomy was performed in 10 mares. Standing laparoscopic ovariectomy was performed using 3 portals in the paralumbar fossa. A commercial polyamide tie-rap was prepared as a loop and marked with 4 colored lines close to the buckle, to enable us to check whether the loop was tightened securely. The ovary was grasped with forceps and after the mesovarium was minimally transected cranially and caudally, the loop of...
Recent advances in equine abdominal surgery. Laparoscopy is a minimally invasive procedure that has applications as a diagnostic, therapeutic and prognostic technique. Specialized equipment is necessary to perform equine laparoscopy, and there is a large range of instruments, both disposable and non-disposable available. Laparoscopic procedures described include ovariectomy, cryptorchidectomy, adhesiolysis and herniorrhaphy. Laparoscopy can be performed in a standing or dorsally recumbent position, depending on surgeon preference, patient status and the procedure to be performed. Stapling equipment is frequently used in gastrointestinal ...
Use of topical mitomycin C in myoplasty of the medial rectus muscle of rabbits. To possibly reduce postoperative adhesions that occur after ocular myoplasties, we investigated the topical effects of 0.04% mitomycin C on the repaired areas of the medial rectus muscle using an equine renal capsule preserved in 98% glycerin for reinforcement of the sutures. Twenty-four rabbits, divided into two groups of 12 animals each [untreated (control) and treated group (MMC)], were submitted to surgical rupture of the medial rectus muscle of one eye and repair of the defect 24 h later with sutures and an equine renal capsule. Post-operative prophylactic treatment of the two groups cons...
Prevention of ischaemia-induced small intestinal adhesions in foals. Treatments addressing variously theorised pathophysiological mechanisms of small intestinal adhesions have been reported. This study applied those classes of treatments to the most clinically relevant aetiology of post operative adhesions. Objective: Treatments addressing the pathophysiology of ischaemia-reperfusion induced adhesions would accordingly reduce the incidence of adhesions from this model. Methods: Four classes of treatments were administered for 72 h to 16 foals subjected to complete ischaemia followed by reperfusion to create peritoneal adhesions. These groups were: 1) FPG group-...
Use of magnetic resonance imaging identify suspensory desmitis and adhesions between exostoses of the second metacarpal bone and the suspensory ligament in four horses. Four horses were examined because of chronic forelimb lameness. In all horses, the cause of the lameness was localized to the metacarpus by means of physical examination and diagnostic anesthesia, and radiography of the affected limb revealed a small exostosis of the second metacarpal bone. Magnetic resonance imaging revealed suspensory desmitis in the region of this exostosis in all 4 horses. In addition, an abnormal area of low signal intensity, suggestive of an adhesion, was seen between the exostosis and the suspensory ligament. In all horses, an adhesion between the suspensory ligament an...
Comparison of two laparoscopic treatments for experimentally induced abdominal adhesions in pony foals. To compare laparoscopic dissection with-laparoscopic dissection combined with abdominal instillation of ferric hyaluronate gel for the treatment of experimentally induced adhesions in pony foals. Methods: 12 healthy pony foals. Methods: A serosal abrasion method was used to create adhesions at 4 sites on the jejunum (day 0). At day 7 laparoscopy was performed and the adhesions observed in each foal were recorded. In group-1 foals (n = 6), the adhesions were separated laparoscopically (treatment 1). In group-2 foals (n = 6), 300 mL of 0.5% ferric hyaluronate gel was infused into the abdomen aft...
Effect of carboxymethylcellulose and hyaluronate solutions on jejunal healing in horses. To compare a double-layer inverting anastomosis with a single-layer appositional anastomosis, coated with either 1% sodium carboxymethylcellulose (SCMC) or 0.4% sodium hyaluronate (HA) solutions, in the small intestine of horses with respect to anastomotic healing and adhesion formation. Methods: 18 adult horses. Methods: Midline celiotomy and end-to-end jejunal anastomoses were performed. In control group horses (n = 6), a double-layer inverting anastomosis coated with sterile lactated Ringer's solution was performed. In treatment group horses, a single-layer appositional anastomosis was perf...
In situ coagulation and transection of the ovarian pedicle: an alternative to laparoscopic ovariectomy in juvenile horses. The feasibility of leaving the ovaries within the peritoneal cavity after laparoscopic coagulation and transection of the ovarian pedicle was assessed in the juvenile horse. Elective ovariectomy was performed on 10 quarter horses, aged 4 to 5 mo, with the fillies in a Trendelenburg position. The mesovarium was isolated, and multiple coagulation and transection cycles were performed until all ovarian attachments had been severed. The ovaries were dropped within the abdomen, and hemostasis of the transected mesovarium was evaluated before closure. The mean surgical time was 33 min (range, 23 to ...
Prevention and treatment of gastrointestinal adhesions. As with many aspects of clinical medicine, there is yet to be a single or definitive cure for postoperative adhesion formation. Current methods of prevention target risk factors predisposing horses to adhesion formation. Systemic pharmacologic therapies, such as antimicrobials, nonsteroidal anti-inflammatory drugs, Salmonella antiserum, and hyperimmune plasma, help to reduce abdominal inflammation and minimize the effects of endotoxemia. Intra-abdominal or systemic heparin aids in enhancing peritoneal fibrinolysis. Prokinetic therapy promotes early postoperative return of intestinal motility, ...
Evaluation of Carolina Rinse solution as a treatment for ischaemia reperfusion of the equine jejunum. Ileus and peritoneal adhesions are the most common complications following surgery for small intestinal obstruction. Carolina Rinse (CR) has been shown to decrease reperfusion injury in intestine and other organs. Objective: CR decreases intestinal inflammation and subsequent scarring associated with reperfusion injury. Methods: CR was infused intra-arterially and applied topically just prior to reperfusion in jejunum exposed to experimental ischemia. Vascular permeability, neutrophil accumulation and serosal scarring were compared in treated and untreated intestine. Results: CR maintained a n...
Healing characteristics of deep digital flexor tenorrhaphy within the digital sheath of horses. To describe the healing characteristics of deep digital flexor tenorrhaphy within the digital sheath. Methods: Experimental study. Methods: Five mature horses. Methods: Right thoracic limb, deep digital flexor tenorrhaphy was performed within the digital sheath. Limbs were cast in partial flexion using a short limb cast for 6 weeks. Next, extended heel shoes were used for limb support for 14 weeks. Healing was evaluated by sequential ultrasonographic examinations, and limb use was evaluated by force plate analysis. At 26 weeks, mechanical strength and morphologic characteristics of the repair ...
Use of an active intra-abdominal drain in 67 horses. To describe the insertion technique, efficacy, and complications associated with the use of an active (closed-suction) abdominal drain in horses. Methods: Retrospective study. Animals-Sixty-seven horses with abdominal contamination treated by abdominal lavage and use of a closed-suction abdominal drain. Methods: Medical records of horses (1989-1996) that had a closed-suction abdominal drain were reviewed. Follow-up information was obtained by telephone interviews with owners. Results: Sixty-eight closed-suction abdominal drains were used in 67 horses that had abdominal contamination, peritonit...
Use of a high-molecular-weight carboxymethylcellulose in a tissue protective solution for prevention of postoperative abdominal adhesions in ponies. To evaluate efficacy and safety of IP administration of high-molecular-weight carboxymethylcellulose (HMW CMC) for the prevention of postoperative intra-abdominal adhesions in ponies. Methods: 10 ponies. Methods: A 1% solution of HMW CMC was instilled intra-abdominally prior to surgery in 5 ponies, whereas 5 control ponies did not receive HMW CMC. Postoperative adhesions were induced by use of a bowel-abrasion method comprising laparotomy, typhlotomy, and abrasion of jejunal serosa at multiple sites with placement of 3 sutures at each site. Day of surgery was day 0. After surgery, ponies were ...
Equid herpesvirus 1 infection of endothelial cells requires activation of putative adhesion molecules: an in vitro model. Antisera to activated equine endothelial cells, which detected surface molecules of 116 kD, 97 kD, 42 kD and 38 kD, were made to investigate the role of endothelial adhesion molecules in equid herpes virus 1 infection. These putative adhesion molecules could be induced by 17-beta oestradiol, chorionic gonadotrophin, or IL-2, as well as by LPS and PWM. In an in vitro flow system, using equine veins or arteries, equid herpesvirus 1 in leucocytes was only transferred to infect endothelial cells if both leucocytes and endothelial cells expressed these surface molecules. Blocking of the membrane mo...
Evaluation of laparoscopic adhesiolysis for the treatment of experimentally induced adhesions in pony foals. To assess the efficacy of laparoscopic adhesiolysis in the treatment of experimentally induced adhesions in foals. Methods: 8 healthy pony foals. Methods: Celiotomy was performed and adhesions created at the jejunoileal junction and at sites 0.5 and 1 m proximal to this junction, using a serosal abrasion method. Ten days after celiotomy, exploratory laparoscopy was performed. Laparoscopic adhesiolysis was performed in the treatment group only (4 foals, randomly selected). Thirty days after the exploratory laparoscopy, a final laparoscopic examination was performed, and the foals were euthanati...
Clinical signs and treatment of chronic uterine torsion in two mares. Two mares were evaluated because of chronic uterine torsions of 2 and 4 weeks' duration; both were pyrectic, anemic, tachycardic, and anorectic, had signs of depression, and had an abnormal uterus and contents on transrectal examination. Both mares underwent cesarean section for lysis of adhesions from the uterus to the peritoneum, correction of the torsion, and ovariohysterectomy Both mares recovered with only minor complications and returned to be used as riding horses. Chronic uterine torsion should be considered in mares in late stages of gestation that have vague clinical signs and transr...
Use of a hyaluronate membrane for jejunal anastomosis in horses. To compare the outcomes of double-layer inverting anastomosis (DIA), single-layer anastomosis (SLA), and single-layer anastomosis combined with a hyaluronate membrane (SLA+HA-membrane) with respect to stomal diameter, adhesion formation, surgery time, and anastomotic healing in horses. Methods: 18 adult horses. Methods: Midline celiotomy and end-to-end anastomoses were performed. In control horses (n = 6), DIA was performed; in treated horses, SLA was performed (6) or SLA+HA-membrane was performed (6). Horses were euthanatized 21 days after surgery. Abdominal adhesions were evaluated grossly a...
One percent sodium carboxymethylcellulose prevents experimentally induced abdominal adhesions in horses. To evaluate the efficacy of 1% sodium carboxymethylcellulose (SCMC) for prevention of experimentally induced abdominal adhesions in horses. Methods: Prospective, controlled, experimental study. Methods: Twelve healthy adult horses. Methods: The effect of 1% SCMC on adhesion formation was evaluated in 12 healthy horses by using an established model of serosal trauma to induce intraabdominal adhesions. After ventral median celiotomy, 2 separate areas of the jejunum were abraded, and three 2-0 chromic gut sutures were placed in each abraded area. Jejunal resection and end-to-end anastomosis was p...
Adherence of eosinophils from allergic and normal ponies to cultured equine endothelial cells. To compare adherence of stimulated and unstimulated eosinophils from allergic and normal ponies to cultured equine vascular endothelial cells (equine digital vein endothelial cells; EDVEC) and examine the effect of eosinophil-derived factor(s) on cell adherence. Methods: Eosinophil adherence to unstimulated EDVEC or EDVEC pretreated with IL-1beta or supernatants from stimulated eosinophils was measured. Supernatants were also assayed for TNFalpha and IL-1beta-like bioactivity. Results: Adherence of unstimulated and rhIL-5 (10 ng/ml)-stimulated eosinophils from allergic ponies to rhIL-1beta-tre...
Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesis. Standing laparoscopic herniorrhaphy was performed in 9 stallions. Appropriate analgesia was achieved by sedation with detomidine and local flank infiltration with mepivacaine. Three portal sites at the paralumbar fossa were used to perform the herniorrhaphy by means of triangulation. A cylindrical polypropylene mesh was inserted and fixated in the inguinal canal. Subsequent adhesion formation resulted in an obliterated inguinal canal within 2 weeks. This minimal invasive technique allowed us to perform a testis sparing herniorrhaphy in the standing horse.
Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse. The records of 74 horses that recovered from anaesthesia after surgery for a small intestinal lesion from 1994 to 1999 were reviewed. Sixty-three horses (85%) had a strangulating lesion and 43 of these (68%) had a resection and anastomosis. Four of 11 horses (36%) without a strangulating lesion had a resection and anastomosis. Sixty-three horses (85%) survived to discharge, with a survival rate of 53/63 in horses with a strangulating lesion (84%) and 10/11 (91%) in others. For all lesions, short-term survival for all end-to-end anastomoses (91%; 21/23) and for no resection (92%; 23/25) were su...
Effects of intraluminal distention and decompression on microvascular permeability and hemodynamics of the equine jejunum. To determine whether intraluminal distention and subsequent decompression of the equine jejunum affects intestinal blood flow, hemodynamics, and microvascular permeability. Methods: 5 healthy adu t horses. Methods: Horses were anesthestized and underwent exploratory laparotomy. Two jejunal segments were identified as sham-operated or instrumented segments. After baseline values were obtained, intraluminal distention was created in the experimental segment to induce an ntraluminal pressure of 18 cm H2O. After 120 minutes of distention, the intestine was decompressed for 120 minutes. Mesenteric ...
Colic surgery in 206 juvenile thoroughbreds: survival and racing results. The purpose of our study was to determine the types of lesions that cause colic in juvenile Thoroughbreds, factors associated with these lesions and the subsequent survival and athletic performance of the juveniles. The age of juvenile Thoroughbreds requiring surgical exploration for abdominal pain has an influence on the type of lesion causing colic. The short-term survival rate (discharge from the hospital) after colic surgery for foals was 85% and was strongly influenced by the lesion causing colic. Thirteen percent of juveniles recovered from the first surgery experienced another severe co...
Effect of carboxymethylcellulose and a hyaluronate-carboxymethylcellulose membrane on healing of intestinal anastomoses in horses. To evaluate the effect of sodium carboxymethylcellulose (SCMC) or a hyaluronate-carboxymethylcellulose membrane (HA membrane) on healing of the small intestine in horses. Methods: 18 healthy adult horses. Methods: Midline celiotomy and 2 jejunal resection-and-anastomosis surgeries were performed. In treated horses, SCMC (n = 6) or a HA membrane (6) was applied to the jejunum to cover the anastomosis. There were 6 untreated control horses. Horses were euthanatized 10 days after surgery. For each horse, 1 anastomosis was used for histologic examination, and the second was used to determine intes...
Evaluation of a bioresorbable hyaluronate-carboxymethylcellulose membrane for prevention of experimentally induced abdominal adhesions in horses. To evaluate the efficacy of a bioresorbable hyaluronate-carboxymethylcellulose membrane (HA-membrane) for prevention of experimentally induced abdominal adhesions in horses. Methods: Experimental study. Methods: Twelve healthy adult horses. Methods: The effect of an HA-membrane on adhesion formation was evaluated in 12 healthy horses using an established model of serosal trauma to induce adhesions. A ventral median celiotomy and two jejunal resections and end-to-end anastomoses were performed. Two separate jejunal areas were abraded, and three 2-0 chromic gut sutures placed in the abraded area...
Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine “complex” digital sheath tenosynovitis. To determine the outcome of horses with "complex" digital tenosynovitis treated by tenoscopic proximal annular ligament desmotomy and resection of synovial masses or adhesions, or both, within the digital sheath. Methods: Retrospective evaluation. Methods: Twenty-five horses with a clinical and ultrasonographic diagnosis of palmar or plantar proximal annular ligament constriction and ultrasonographic evidence of synovial masses or adhesions within the digital tendon sheath. Methods: Each horse had tenoscopic surgery for annular ligament desmotomy combined with adhesiolysis and/or synovial mass...