한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제20권1호
  • /
  • Pages.12-21
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  • 2003
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  • 1598-298X(pISSN)
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  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지

개에서 세가지 단단장문합 봉합법에 따른 유착비교

A Comparison of Three Suture Techniques on Adhesion in End-to-end Intestinal Anastomosis of Dogs

  • Kim, Je-Sun (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Jeong, Soon-Wuk (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Kim, Joon-Young (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Jeong, Man-Bok (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Han, Hyun-Jung (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University)
  • 발행 : 2003.03.01
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초록

이 연구에서는 개의 소장에 세가지 장문합법이 유착에 어떠한 영향을 미치는 지 알아보았다. 스물 여섯 마리의 개를 무작위로 세 군으로 나누었다. Group I은 단순 연속봉합을 실시하였고, Group II은 단순 결절 접합봉합을 실시하였으며, Group III는 단층 연속 코넬 봉합을 실시하였다. 모든 실험견에 단단장문합술 후 대망막이식을 실시하고, 복막을 닫기 바로 전에 1% Sodium carboxymethylcellulose을 체중 kg 당 5ml되는 용량으로 복강안에 주입하였다. 수술후 14일째 되는날 실험견들의 수술후의 유착소견을 관찰하였다. 모든 개에서 장문합 부위와 대망막 이식 부위 사이의 유착이 발견되었으며, 장막끼리의 유착이 Group I에서 두 마리, Group II에서 세미리, Group III에서 세 마리가 관찰되었다. 모든 군의 평균 유착 점수는 2이하였다. 장문합부와 대망막사이의 유착길이는 Group I에서 13.13$\pm$4.97mm(mean$\pm$S.D.), Group II에서 17.29$\pm$4.68mm, Group III에서 14.64$\pm$3.80mm가 관찰되었다. 단순 연속 봉합법이 유착을 가장 적게 일으켰고, 단순 결절 접합 봉합법이 가장 유착을 많이 일으켰다. 그러나 유착정도에 있어서 세가지 봉합법의 유의성 있는 큰 차이는 나타나지 않았다. 수술후 합병증인 장중적이 한 마리에서만 나타났고, 수술후 생존하였다. 14일간 매일 체온, 활력, 식욕, 배변 및 배뇨를 관찰하였다. 모두 정상범위에 속했으며, 군간의 뚜렷한 차이는 없었다. 결론적으로 개에서 세가지 단단장문합 봉합법이 유착정도에 미치는 영향에서 군간 유의성 있는 차이가 관찰되지 않았지만, 단순 연속 봉합법이 유착을 가장 적게 일으키므로 단단장문합법시에 다른 두기지 봉합법보다 더 권장될 수 있을것이라 사료된다.

In this study, we evaluated effects of three anastomotic techniques of small intestine on adhesions in the dog. Twenty six healthy mixed dogs were randomly assigned to three groups. Group I(n = 8) was sutured with a simple continuous suture, group II(n = 7) was sutured with a simple interrupted approximating suture and group III(n = 11) was sutured with a single layer continuous Connell suture. On completion of any intestinal anastomosis, a pedicle of greater omentum was wrapped around the suture line in all experimental dogs. One percent sodium carboxymeth-ylcellulose (5ml/kg) was administrated into the abdomen by feeding tube prior to closing the last part of peritoneum in all dogs. Postoperative adhesions were evaluated at 14th day after operation. The adhesions consisted primarily in two dogs in group I, three dogs in group II and group III. There were adhesions between intestinal serosal surfaces in eight dogs in all groups, but there were no intestinal serosa-visceral peritoneum adhesion and intestinal serosa-mesentery adhesion. Mean adhesion scores were less than score 2 in all groups. Between anastomotic site and omental graft, there were 13.13$\pm$4.97 mm (mean$\pm$S.D.) adhesion formation in group I and 17.29$\pm$4.68 mm in group II and 14.64$\pm$3.80mm in group III. A simple continuous suture resulted in the least adhesion formation and a simple interrupted approximating suture resulted in the greatest adhesion formation among the groups. However, there were no significant differences among three suture techniques in the severity of adhesions. Intestinal intussusception only encountered in one dog during the 14 days, the dog operated and survived. Daily monitoring of temperature, activity, appetite, defecation and micturition were done. All of those vital signs were within normal values and there were no obvious differences among the groups. In conclusion, even though there were no significant differences among three groups, a simple continous suture pattern is recommended to prevent adhesions when operating intestinal anastomosis in dogs.

키워드

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