DOI
https://doi.org/10.18849/ve.v4i3.243Abstract
PICO question
In dogs that undergo intestinal surgery, does the use of monopolar electrosurgery for intestinal incisions increase the risk of dehiscence when compared to a scalpel blade?
Clinical bottom line
Currently there are two experimental in vivo studies comparing electrosurgery with scalpel blade intestinal incisions in dogs, one in cats and one in pigs. In dogs and cats, there is data regarding incisions on the large intestine but not the small intestine.
Colotomy and colectomy performed with monopolar electrosurgery has resulted in significant mortality (up to 60%) during the short-term postoperative period in dogs. Although the studies reviewed have several limitations, the outcome using scalpel blades was significantly better, therefore colonic surgery using electrosurgery is contraindicated. It is likely that small intestinal surgery has the same contraindication but more definite conclusions cannot be made until higher quality evidence is available.
References
Hottenrott, V.C., et al. (1983) Anastomotic problems in colonic surgery. Zentralblatt fur Chirurgie. 108: 1263–1271.
Kott, I., and Lurie, M. (1973) The effects of electrosurgery and the surgical knife on the healing of intestinal anastomoses. Diseases of the Colon & Rectum. 16: 33–38. DOI: http://dx.doi.org/10.1007/BF02589907
Pollinger, H.S., et al. (2003) Comparison of wound-healing characteristics with feedback circuit electrosurgical generators in a porcine model. The American Surgeon. 69: 1054–1060.
Regadas, S.M.M., et al. (2005) Experimental model of laparoscopic handsewn suture in colon of dogs. Acta Cirúrgica Brasileira 20: 323–328. http://dx.doi.org/10.1590/S0102-86502005000400011
Spalding, H., and Heath, T. (1987) Arterial supply to the pig intestine: an unusual pattern in the mesentery. Anatomical Record. 218: 27–29. DOI: http://dx.doi.org/10.1002/ar.1092180106
Thornton, F.J., and Barbul, A. (1997) Healing in the gastrointestinal tract. Surgical Clinics of North America. 77: 549–573. DOI: https://doi.org/10.1016/S0039-6109(05)70568-5
Williams, J.M. (2017) Colon. In: Veterinary Surgery: Small Animal, 2nd, eds K.M. Tobias, S.A. Johnston, Elsevier, St. Louis, MO, USA, pp. 1767–1771.
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