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Introduction: The objective of this study was to evaluate the use of LASER Doppler flowmetry and spectrophotometry (LDFS) for intraoperative assessment of small intestinal viability.
Materials and methods: In this prospective clinical study, 40 horses diagnosed with small intestinal strangulations were included. LDFS measurements including tissue blood flow (tBF) and tissue oxygen saturation (tO2SAT) were performed before and after release of the strangulation. Intestinal injury was visually assessed using a semiquantitative score (VIS, 0-5). Samples of the strangulated intestinal segment were analysed histopathologically with a mucosal injury score (MIS, 0-6) in cases that underwent intestinal resection or intraoperative euthanasia. LFDS measurements were compared between the different categories of VIS and MIS using a Kruskal-Wallis test.
Results: Intestinal segments with a high VIS (4-5/5) showed decreased tBF compared to those with low VIS (2-3/5). Strangulations by pedunculated lipomas had lower tBF than epiploic foramen entrapments. tO2SAT prior to release of the strangulation as well as tBF after reperfusion were higher in cases that did not undergo intestinal resection compared to cases with resection. Severely affected intestinal segments (MIS 5-6/6 - structural deterioration and crypt necrosis) showed lower tBF during strangulation than segments with mild to moderate MDS (1-4/6 - epithelial separation without crypt involvement).
Discussion/conclusions: The results indicate that blood flow measurements prior to release of the strangulation may aid in the determination of intestinal viability. The main limitation of the study is that no histological examination was performed in the less severely damaged intestinal segments that did not undergo resection.
33rd Annual Scientific Meeting proceedings
Stream:
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Session:
Date/Time: 30-11--0001 (00:00 - 00:00) | Location:
Date/Time: 30-11--0001 (00:00 - 00:00) | Location:
LASER Doppler flowmetry and spectrophotometry as ancillary diagnostic method to determine intestinal viability in horses with strangulating small intestinal lesions
Verhaar N*1, Kästner SBR1, Grages AM1, Bienert-Zeit A1, Schwieder A1, Sauer F1, Geiger T1, Reineking W2, Hewicker-Trautwein M2, Geburek F*1
1Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany, 2Institute for Pathology, University of Veterinary Medicine Hannover, Hannover, Germany.
Introduction: The objective of this study was to evaluate the use of LASER Doppler flowmetry and spectrophotometry (LDFS) for intraoperative assessment of small intestinal viability.
Materials and methods: In this prospective clinical study, 40 horses diagnosed with small intestinal strangulations were included. LDFS measurements including tissue blood flow (tBF) and tissue oxygen saturation (tO2SAT) were performed before and after release of the strangulation. Intestinal injury was visually assessed using a semiquantitative score (VIS, 0-5). Samples of the strangulated intestinal segment were analysed histopathologically with a mucosal injury score (MIS, 0-6) in cases that underwent intestinal resection or intraoperative euthanasia. LFDS measurements were compared between the different categories of VIS and MIS using a Kruskal-Wallis test.
Results: Intestinal segments with a high VIS (4-5/5) showed decreased tBF compared to those with low VIS (2-3/5). Strangulations by pedunculated lipomas had lower tBF than epiploic foramen entrapments. tO2SAT prior to release of the strangulation as well as tBF after reperfusion were higher in cases that did not undergo intestinal resection compared to cases with resection. Severely affected intestinal segments (MIS 5-6/6 - structural deterioration and crypt necrosis) showed lower tBF during strangulation than segments with mild to moderate MDS (1-4/6 - epithelial separation without crypt involvement).
Discussion/conclusions: The results indicate that blood flow measurements prior to release of the strangulation may aid in the determination of intestinal viability. The main limitation of the study is that no histological examination was performed in the less severely damaged intestinal segments that did not undergo resection.
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