Judul : Teknik Operasi Perianal Fistula dan Fistula Rectovaginalis pada Hewan (Bedah Digesti)
link : Teknik Operasi Perianal Fistula dan Fistula Rectovaginalis pada Hewan (Bedah Digesti)
Teknik Operasi Perianal Fistula dan Fistula Rectovaginalis pada Hewan (Bedah Digesti)
Today the development of technology is increasing rapidly in the field of veterinary medicine especially in the field of surgery.
One type of surgery that can be performed on animals if needed is the digestive tract. Surgery is performed in this area to repair or overcome problems with the digestive system.
Because digestion becomes one of the points of vulnerability for the occurrence of diseases or abnormalities that can be harmful to animals.
However, also keep in mind that digestive surgery must be done very carefully as it plays a very large role in the body's digestive process.
Types of surgery, one of which is perianal fistula surgery and rectovaginal fistula surgery. Perianal fistula and fistula rectovaginalis surgery is important in management if abnormalities occur.
Definition of operative perianal fistula and rectovaginal fistula
A perianal fistula is a deep, highly developed channel that collects pus in the perianal tissue. Perianal is often seen in large breed dogs. Refers to perianal fistula, perianal sinus, perianal fissure, furunculosis, pararectal fistula, anusitis, ono- and anorectal abdominal cavity fistula.
Perianal fistula
Perianal refers to the area around the anus or the end of the digestive tract. An abnormality is a connection where a fistula forms between two tissues, organs or vessels that are not normally connected.
In affected dogs, the condition is usually associated with an infection in the perianal area and usually has one or more drainage ducts that are engorged.
Rectovaginal fistulas are abnormal junctions that occur between the dorsal wall of the vagina and the ventral portion of the anus, so that the vulva serves as a common channel for the urogenital tract and digestive system.
Another definition states that rectovaginal fistula surgery is an operation performed between the anus and vagina due to partial obstruction of the labia either naturally or due to trauma.
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| Anatomy of the anus in the anus. |
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| Perianal Fistula and Fistula in Dogs |
Pathogenesis
The formation of perianal fistulas in the rectal glands located in the crypt of the rectal column acts as a barrier to the passage of microorganisms that cause infection from the intestinal lumen to the perirectal area. It indicates a type of mucus, useful as a lubricant.
This line has a one-way valve so that production can go out but not in.
Due to stasis, production from this gland is inhibited, allowing bacteria and feces to enter the fluid gland.
Stools in which many germs multiply in the glands, causing inflammation that leads to abscesses. The abscess will find a way out and form a type of tube that penetrates the skin. As a result, the skin looks like an abscess and then breaks off.
This chunk cannot close because the naankh always comes out and cannot dry because it is in contact with the faeces. The infection initially enters through the gland and spreads to the wall of the rectal sphincter causing anorectal abscess.
The abscess ruptures spontaneously, eventually leaving a scar in the form of granulation tissue along the canal, causing recurrent symptoms. This condition can be extended from months to years.
Perianal fistula procedures focus on destruction of the epithelial lining of the sinus tract or complete excision of the canal block to remove tissue and prevent disease recurrence.
A rectovaginal fistula is an abnormal channel between the lower part of the large intestine or the rectum and vagina. Due to this condition, intestinal contents can leak through the fistula allowing the affected person to pass gas or stool through the vagina.
Rectovaginal fistulas are associated with failure of the urorectal folds to properly cloaca the fetus. Sinovaginal lump cloaca does not form a continuous opening and persists from the transition of the anal opening to the vestibular region or vaginal area.
The fistula connects the dorsal vaginal wall to the ventral anus, which often ends as a non-functional canal.
Indications for perianal fistula and rectovaginal fistula surgery
Most fistulas originate in the anus or glands deep in the rectal wall. Sometimes an anorectal fistula results from the discharge of pus into the abdominal muscles. The reason is not visible.
Organisms involved in abscess formation are Escherichia coli, Enterococcus sp and Bacteroides sp.
Fistulas are also found in patients with tuberculosis (TB), diverticulitis, cancer or rectal or rectal injury, actinomycosis, and chlamydial infection.
Perianal fistula surgery is also done to remove disorders of the anus to keep the digestive system smooth and uninterrupted, prevent hypofunction of the anus, prevent tumors and others.
Hint line:
- The animal has difficulty defecating and seems happy with whooping
- Dance with defecation (in female animals)
- Stomach looks bloated and hard due to prolonged accumulation of food in the digestive system.
- Animals tend to lift their tails or appear to hang in part or experience rectovaginalis and are at risk of faecal bacterial infections.
- Incidence of hypothyroidism
Anesthesia operation perianal fistula and rectovaginal fistula
2 The anesthesia used for the operation is general anesthesia. General anesthesia can be used in dogs and cats
Horses were premedicated with midazolam at 0.1 mg/kg intravenously followed by induction of anesthesia using 2.2 mg/kg ketamine hydrochloride intravenously.
Then support anesthesia with halothane and inhalation of oxygen. The horse is placed in the sternum decubitus position. A pool of 3 ml mepivacaine hydrochloride solution was given and injected epidurally and analgesia 0.1 mg/kg morphine sulfate and 2 mg/kg ketoprofen was given.
Perianal fistula and rectovaginal fistula surgical techniques
Perianal Fistula Surgery Technique
on the dog
A perianal fistula can be treated surgically by making an incision in the gland.
- The surgical technique involves first irrigating the anal glands with a weak antiseptic solution and inserting several yards of sponge into the anus to prevent contamination from the stool.
- Next, the rectal gland is excised using a notched guide into the rectal gland through the orophossium, then an incision is made to expose the border of the gland and the glandular sac, which is separated by blunt preparation.
- Next, close the incision using chrome catgut size 2-0 and an absorbable bang for the exterior with a single interrupted suture pattern.
- Furthermore, a continuum is created around the hellish fistula. The segment is separated up to the anal sphincter and attempts are made to maintain the anal sphincter.
- The rectal submucosal layer around the anus was sutured to the subcutis using 2-0 chrome catgut, and the mucosa was sutured to the skin using non-absorbable sutures.
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| Perianal fistula in dogs |
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| separate from the intersection |
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| After recovering from surgery |
In didang surgery, other steps taken by veterinarians to treat perianal fistulas are cyrosurgical or cyrosurgery and so far clinical trials and studies have been conducted as an adjunct and evaluation of cyrosurgical from a clinical perspective.
Before viewing rosary surgery, animals were anesthetized using xylazine hydrocorrida and played with cerebral decubitus or lateral decubitus.
The perianal area is cleaned and prepared before taking biopsy material to identify if there is a tumor around the perianal area.
Cirrosurgery
In this case, a digital chirosurgery unit works with the LİMSA MC-3000 model Joule-Thompson effect unit that displays electricity that can be shown digitally on the thermometer probe and uses carbon dioxide as a freezing agent.
Cooling of the rectal region is carried out simultaneously with the insertion of the probe into the rectum, and rectal protection is also done by inserting a sponge gauze. Treatments were carried out twice with temperatures ranging from -30oC to -50oC.
The area around the anus is frozen to wait before natural death occurs and the area is left without parenteral or local antibiotics and this is continued every week.
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| Examples of probes for cryosurgical treatment |
on a horse
- The surgical technique was carried out by isolating and demarcating the mucosal edge using blunt dissection of the mucosal segment using the anus.
- The rectal mucosa was then sutured to the rectal lumen using 3 metric gauge polydioxanone with a continuous horizontal mattress suture pattern.
- The submucosal anus was then closed using a simple continuous pattern on the subcutaneous portion, and the perianal muscle was also closed with the same suture pattern.
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| Horses with a position located on the chest |
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| One year after surgery, the fistula was gone |
Rectovaginal fistula surgery technique
Rectovaginal fistulas are treated by two methods. In the first method, the rectal and valvular lips were disturbed separately after fistula isolation and transection. Reconstruction is done after opening the anus.
In the second method, rectal care is performed only in the anterior part of the fistula, the affected part of the anus is cut and sutured to the outside of the anus and the exposed edge of the skin.
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| Rectovaginal Pads-Dog-Female-Set 1 Month. |
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| Dissection of a rectovaginal fistula in a female cow. |
Postoperative treatment of perianal fistula and rectovaginal fistula
Treatment of perianal fistula and rectovaginal fistula
Postoperative care is performed according to the existing condition of the patient, if you do not want to give an infusion, to prevent the administration of antibiotics, to avoid the administration of anti-inflammatory drugs.
Then periodically check the operated parts to accurately detect if there is any abnormality.
In general, there are 3 principles of postoperative perianal fistula care , namely:
A. Immunosuppressant or immunomodulatory therapy
There are 2 stages:
- induction phase. To overcome the clinical symptoms shown
- Cyclosporine: 4-8 mg/kg given orally per fistula.
- Cyclosporine and Ketoconazole: Cyclosporine 0.5-5 mg/kg PO, Ketoconazole 5-7.5 mg/kg PO
- Tacrolimus: Kecil is given in quantity
- Prednisolone: 2 mg/kg po daily until wound recovery then 1 mg/kg daily
- Azathioprine: 2 mg/kg orally, then 1 mg/kg orally until wound recovery
- maintenance phase. To prevent recurrence of disease.
- Cyclopsorine with or without ketoconazole. Lower doses with less frequent administration to maintain wound regulation, and may be discontinued
- tacrolimus
- Prednisolone 0.5-1 mg/kg with infrequent administration, may be discontinued if necessary
- Azathioprine: 1 mg/kg, alba can be substituted
b. Therapeutic nutrition
New and hydrolyzed protein inhibition.
Opposite healthy therapy
- Keep the area dry and clean
- Berican antibiotic therapy
Postoperative treatment of rectovaginal fistula
- Administration of penicillin-streptomycin antibiotic for 5 hours, IM
- Administration of NSAIDs, for several days
- Washing (irrigating) with normal saline solution 2 times a day, followed by application of neomycin sulfate
- Thread (silk) taken 14 hours after surgery
on a horse
ঘোড়াকে 22000 IU/kg এ অ্যান্টিবায়োটিক দেওয়া হয়েছিল ইন্ট্রামাসকুলার প্রোকেইন বেনজিলপেনিসিলিন, সাবকুটেনিয়াস টিটেনাস অ্যান্টিটক্সিন 1500 IU/kg এবং ওমেপ্রাজল 4 মিলিগ্রাম/কেজি পোস্টঅপারেটিভ রক্ষণাবেক্ষণের সময়।
অস্ত্রোপচারের পরে বিশেষ করে ঘোড়ার মলত্যাগের সময়, ম্যাগনেসিয়াম সালফেট এবং লবণ মৌখিকভাবে মলকে নরম করার জন্য দেওয়া হয় যাতে অস্ত্রোপচার এবং সেলাই করা না হয়।
অস্ত্রোপচারের নয় দিন পর সুস্থ ত্বকের টিস্যুর বৃদ্ধি দেখা যায়।
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চিকিত্সার পরে রেক্টোভাজিনাল ফিস্টুলা। |
স্পিকার
ব্যাডেমকিরান, সার্ভেট এট আল 2009। গবাদি পশুর মলদ্বারে অ্যাট্রেসিয়া সহ জন্মগত রেক্টোভাজিনাল ফিস্টুলা: একটি কেস রিপোর্ট। তুরস্ক: ডিকল বিশ্ববিদ্যালয়।
অ্যালিসন, গ্যারি ডব্লিউ. 2009. পেরিয়ানাল ফিস্টুলা/অ্যানাল ফিস্টুলা; যেসব রোগে মাঝে মাঝে অস্ত্রোপচারের প্রয়োজন হয়। ফ্লোরিডা: ফ্লোরিডা বিশ্ববিদ্যালয়।
কার্নি, কেএম এবং পিজে পোলক। 2006. খাঁটি জাতের বাচ্চাদের মধ্যে জন্মগত পেরিয়ানাল ফিস্টুলা। সংক্ষেপে সংবাদ: ভেটেরিনারি ফাইল।
Nat, I., VSK Bosee et al. 2004. সাদা বাঘের বাচ্চাদের মধ্যে পেরিয়ানাল ফিস্টুলা। ভারত: চিড়িয়াখানা প্রিন্ট জার্নাল 17(1): 690, ওড়িশা স্কুল অফ ভেটেরিনারি মেডিসিন।
পিপার, জেসন এবং লিন্ডসে ম্যাককে। 2011. পেরিয়ানাল ফিস্টুলা। পশুচিকিত্সকদের জন্য অবিরত শিক্ষা সারাংশ: মার্কিন যুক্তরাষ্ট্র।
সালগাম, মেহমেদ ও ঐক্য কেয়া। 2006. কুকুরের মলদ্বার ফিস্টুলার সাইরোসার্জিক্যাল চিকিৎসা। ভেটেরিনারি এবং ভেটেরিনারি সায়েন্সের তুর্কি জার্নাল: টিউবিটাক।
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