Köpeklerde Perineal Fıtıkların Sağaltımında Dört Tekniğin Bir Arada Kullanılmasının Nüksleri Önlemedeki Etkinliği: Obturator Internus Kas Transpozisyonu, Kastrasyon, Sistopeksi ve Kolopeksi

Year 2017, Volume: 12 Issue: 3, 259 - 268, 20.12.2017

Murat Karabağlı

https://doi.org/10.17094/ataunivbd.294845

Abstract

Perineal
fıtık, pelvik diyaframı oluşturan bileşenlerin güçsüzlüğü sonucu, idrar kesesi,
bağırsaklar, retroperitoneal yağ doku veya prostat gibi intraabdominal yapı ve
organların perineal bölgeye fıtıklaşmasıdır. Tedavisinde klasik herniorafi
dışında farklı kasların transpozisyonu, çeşitli prostetik implantlar ve
biomateryaller kullanılmaktadır. Çalışmamıza farklı ırk ve yaşta 11 adet erkek
köpek dahil edildi. Hastalar, perineal bölgede şişlik, ağrılı defekasyon,
dışkıda kan ve strangüri gibi şikayetlerle getirilmişlerdi. Perineal fıtık
tanısı, klinik muayene ve rektal palpasyon bulgularına göre kondu. Perineal
fıtık tanısı konan 11 hastadan 10 ‘u, obturator internus kas transpozisyonu,
kastrasyon, sistopeksi ve kolopeksi işlemleri aynı seansta uygulanarak sağaltıldı
ve hastalar kısa ve uzun dönem nüks ve diğer bazı komplikasyonlar açısından
değerlendirildi. Bir hastada ise hasta sahibi yavru almak istediği için
kastrasyon yapılamadı. Çalışmanın sonucunda 11 hastanın 10 ‘unda uzun dönem
nüks şekillenmedi. Önemli sayılabilecek bir postoperatif komplikasyonla
karşılaşılmadı. Sonuç olarak, postoperatif nüks oranları %36-48 lere kadar
ulaşabilen perineal fıtıkların sağaltımında, obturator internus kas
transpozisyonu, kastrasyon, sistopeksi ve kolopeksinin eş zamanlı
uygulanmasının postoperatif uzun dönem nüksleri engellemede faydalı olabileceği
kanısına varıldı.

Keywords

Kastrasyon, Köpek, Obturator internus kası, Organopeksi, Perineal fıtık

Prevention of Perineal Hernia Recurrences by Four-In-One Procedure in Dogs: Obturator Internus Muscle Transposition, Castration, Cystopexy and Colopexy

Abstract

Perineal hernia is caudal dispacemet of intraabdominal
structure and organs such as the urinary bladder, intestines, retroperitoneal
fat or prostate to the perineal region because of weakness and deficiency of
pelvic diaphragm. In treatment, different muscle transposition tecniques,
various prosthetic implants and biomaterials are used beside of traditional
herniography. Eleven male dog with different age and breed was included in this
study. These patients were brought by the complaints of perineal swelling,
blood in feces, painful defecation and stronguria. Perineal hernia diagnosis
was made by clinical examination and rectal palpation. Perineal hernias was
treated by obturator internus muscle transposition, castration, cystopexy and
colopexy in the same session in 10 of 11 patient and the postoperative
complications and short and long term recurrence was evaluated. In one patient,
owner of the dog did not give permission to castration since he wanted to use
his dog for breeding. At the end of the study, postoperative long term
reccurrence was not determined in 10 of 11 patient. No significant
postoperative complications were noted. As a result, in the treatment of
perineal hernias that have postoperative recurrence rates up to 36-48%, it was
concluded that simultaneous using of obturator internus muscle transposition,
castration, cystopexy and colopexy can be useful in preventing postoperative
long term recurrence in dogs.

Keywords

Castration, Dog, Obturator internus muscle, Organopexy, Perineal hernia

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