Köpeklerde endoskopik cerrahinin tanı ve sağaltım olasılıkları
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Date
2004-06-08
Authors
Sağlık, Yakup
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışma. Şubat 2001- Mayıs 2003 tarihleri arasında U.Ü. Veteriner Fakültesi Cerrahi Anabilim Dalında yapılmıştır. Çalışma değişik ırk, yaş, cinsiyet ve ağırlıktaki köpeklerden oluşan 70 olguda gerçekleştirilmiştir. Bu çalışmada, insanlarda genel cerrahi, jinekoloji ve üroloji atanlarında, son yıllarda yaygın olarak kullanım alanı bulan endoskopik cerrahinin, köpeklerdeki tanı ve sağaltım olanaklarının değerlendirilmesi amaçlanmıştır. Çalışma 2 grupta yürütülmüş, 1. grupta 3 5 köpekte laparoskopik muayene, biyopsi ve cerrahi işlemleri, 2. grupta 35 köpekte sistoskopik muayene, biyopsi, retrograd üreterografı ve pyelografi işlemleri yapılmıştır. Çalışmada 1. grupta Kari Storz endoskopi seti, 2. grupta Richard Wolf sistoskopi seti, ekipmanları ve aletleri ile birlikte kullanılmıştır. 1. gruptaki 35 köpekte karaciğer, safra kesesi, böbrekler, dalak ve pankreas laparoskopik muayeneleri yapılarak, ilgili organlardan biyopsi materyalleri alınmıştır. Aynı gruptaki 8 köpekte vazektomi, 6 köpekte ovariektomi, 3 köpekte kornu uterilerin ligasyonu, 8 köpekte kolesistektotni ve 5 köpekte nefrektomi işlemleri gerçekleştirilmiştir. 2. gruptaki 35 köpekte idrar kesesinin sistoskopik muayeneleri yapılarak, özel biyopsi pensi ile kese çeperinden biyopsi örnekleri alınmıştır. Bu işlemler sırasında 10 olguda steril idrar örnekleri alınmıştır. 5 olguda ise retrograd üreterografı ve pyeiografi işlemleri gerçekleştirilmiştir. Laparoskopik organ muayenelerinde saptanan organlara ilişkin normal ve patolojik görüntüler, biyopsi materyallerinin incelenmesi ile konulan histopatoiojik tanılarla karşılaştırılmış ve laparoskopik muayenelerin tanıdaki önemi değerlendirilmiştir. Organlara ilişkin renk. boyut, kıvam, yüzey ve kenar yapılarındaki değişiklikler muayeneler sırasında saptanan patolojik görüntülerdir. Laparoskopik biyopsi alma işlemlerinin ve biyopsi materyallerinin değerlendirilme sindeki incelenebilirlik kalitesi ile ilgili organlarla uyumu konusunda elde edilen bulgular, diğer biyopsi alma yöntemlerine göre daha güvenilir ve tanıya ulaşmada daha kesin bulgular olarak değerlendirilmiştir. Belirtilen laparoskopik cerrahi girişimler, kaynak bilgilerdeki yöntemlere özen gösterilerek yapılmış, ilk defa yapılan uygulamalar olmasına rağmen önemli bir güçlük ve komplikasyonla karşılaşılmamıştır.Sistoskopik muayenelerde normal ve yangılı kese mukozaları net olarak incelenmiş, değişik yerlerden alman biyopsi örneklerinin incelenmesi ile elde edilen sistitis tanısının ve değişik formlarının sağaltım aşamasında yönlendirici olacağı anlaşılmıştır. Ancak sistoskopi yapılarak gerçekleştirilebilen refrograd üreterografi ve pyelografi görüntüleri net olarak incelenmiştir. Sonuç olarak insanlarda son yıllarda minimal invaziv bir yöntem olarak rutin muayene ve cerrahi işlemlerde uygulanan endoskopi işlemlerinin, köpeklerde de cihaz, ekipman ve alet temini gibi güçlükler aşıldığında başarıyla gerçekleştirilebileceği anlaşılmıştır.
This study was performed on 70 dogs, different breed, ages, sex and weight, between February 200 i - May 2002 in Uludağ University Veterinary Faculty Department of Surgery. in this study, it was aimed to evaluate the diagnostic and therapeutic possibilities of endoscopic surgery which commonly used in human surgery, gynaecology and urology recently, in dogs. This study carried out in two groups. In first group which consisted of 35 dogs, laparoscopic examination, biopsy and surgery procedures were performed, in second group which consisted of 35 dogs, cystoscopic examination, biopsy, retrograde ureterography and pyelography were performed. Karl Storz endoscopy unit and instrument were used in the first group, Richard Wolf rigid cystoscop and equipment were used in the second group. Laparoscopic liver, spleen, kidneys, pancreas examination and biopsy were performed on 35 dogs in the first group. In the same group vasectomy in 8 dogs, ovariectomy in 6 dogs, hom body ligation in 3 dogs, cholecystectomy in 8 dogs, nephrectomy in 5 dogs were performed. Cystoscopic examination and biopsy were performed on 35 dogs in the second group. Steriie urine samples were collected in 10 cases. Retrograde ureterography and pyelography were performed in 5 dogs. Normal and pathological organ apperances which were determined in laparoscopic examination, compared with histopathoiogical diagnosis which were determined with examination of organ biopsy samples. Importance of laparoscopic examination in diagnosis was evaluated. It was evaluated that diagnostic quality of biopsy specimens which were taken with laparoscopy was more superior than other diagnostic methods and laparoscopy was more reliable than other diagnostic methods to obtain biopsy specimens. No important complication or difficulty was encountered when applying laparoscopic surgery procedures which were described on literatures. Normal and pathological bladder were examined dearly with cystoscope. It was determined that histopathoiogical diagnosis which was determined with examination of biopsy samples, can quide to treat different form of cystitis and evaluate the prognosis of cystitis. IVAs a result, it was concluded that endoscopy procedures that are commonly used for routine examinations and surgery as a minimal invasive method in human surgery recently, can be performed succesfully in dogs when difficulties like apparatus, equipment and instrument are achieved.
This study was performed on 70 dogs, different breed, ages, sex and weight, between February 200 i - May 2002 in Uludağ University Veterinary Faculty Department of Surgery. in this study, it was aimed to evaluate the diagnostic and therapeutic possibilities of endoscopic surgery which commonly used in human surgery, gynaecology and urology recently, in dogs. This study carried out in two groups. In first group which consisted of 35 dogs, laparoscopic examination, biopsy and surgery procedures were performed, in second group which consisted of 35 dogs, cystoscopic examination, biopsy, retrograde ureterography and pyelography were performed. Karl Storz endoscopy unit and instrument were used in the first group, Richard Wolf rigid cystoscop and equipment were used in the second group. Laparoscopic liver, spleen, kidneys, pancreas examination and biopsy were performed on 35 dogs in the first group. In the same group vasectomy in 8 dogs, ovariectomy in 6 dogs, hom body ligation in 3 dogs, cholecystectomy in 8 dogs, nephrectomy in 5 dogs were performed. Cystoscopic examination and biopsy were performed on 35 dogs in the second group. Steriie urine samples were collected in 10 cases. Retrograde ureterography and pyelography were performed in 5 dogs. Normal and pathological organ apperances which were determined in laparoscopic examination, compared with histopathoiogical diagnosis which were determined with examination of organ biopsy samples. Importance of laparoscopic examination in diagnosis was evaluated. It was evaluated that diagnostic quality of biopsy specimens which were taken with laparoscopy was more superior than other diagnostic methods and laparoscopy was more reliable than other diagnostic methods to obtain biopsy specimens. No important complication or difficulty was encountered when applying laparoscopic surgery procedures which were described on literatures. Normal and pathological bladder were examined dearly with cystoscope. It was determined that histopathoiogical diagnosis which was determined with examination of biopsy samples, can quide to treat different form of cystitis and evaluate the prognosis of cystitis. IVAs a result, it was concluded that endoscopy procedures that are commonly used for routine examinations and surgery as a minimal invasive method in human surgery recently, can be performed succesfully in dogs when difficulties like apparatus, equipment and instrument are achieved.
Description
Keywords
Köpek, Endoskopik cerrahi, Sistoskopi, Tanı, Sağaltım, Dog, Endoscopic surgery, Cystoscopy, Diagnosis, Treatment
Citation
Sağlık, Y. (2004). Köpeklerde endoskopik cerrahinin tanı ve sağaltım olasılıkları. Yayınlanmamış doktora tezi. Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.