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비글견에서 복강경을 이용한 위관삽입술의 유용성 평가 연구

Feasibility Study of Laparoscopic Gastrostomy Tube Placement in Beagle Dogs

  • 이재웅 (충남대학교 수의과대학.동물의과학연구소) ;
  • 박지영 (충남대학교 수의과대학.동물의과학연구소) ;
  • 이해범 (충남대학교 수의과대학.동물의과학연구소) ;
  • 정성목 (충남대학교 수의과대학.동물의과학연구소)
  • Lee, Jae-Woong (College of Veterinary Medicine, Research of Veterinary Medicine, Chungnam National University) ;
  • Park, Ji Young (College of Veterinary Medicine, Research of Veterinary Medicine, Chungnam National University) ;
  • Lee, Hae-Beom (College of Veterinary Medicine, Research of Veterinary Medicine, Chungnam National University) ;
  • Jeong, Seong Mok (College of Veterinary Medicine, Research of Veterinary Medicine, Chungnam National University)
  • 심사 : 2015.02.14
  • 발행 : 2015.02.28

초록

본 연구는 개에서 복강경 위관삽입술(LG)을 시행, 수술시간, 합병증, 유착부를 평가하여 수의분야에서 LG의 유용성을 내시경 유도하 경피 위관삽입술(PEG)에 준하여 확인하였다. 정상 비글견 8마리를 두 군으로 나누어 Tri-Funnel Replacement Gastrostomy tube (Bard Inc., USA, 20 Fr.)와 PEG kit (Ponsky "Pull" PEG Kit$^{(R)}$, Bard Inc., USA, 20 Fr.)를 이용하여 LG 및 PEG를 실시하였다. 위관을 통한 영양 공급은 유지 열량 요구량(MER)을 1일 3회로 나누어 2주간 진행하고 LG와 PEG의 수술 중, 수술 후, 사후로 나누어 평가하였다. 모든 개체에서 위관삽입은 성공적이었고, PEG 군에서의 평균 수술 시간이 LG군에 비해 유의적으로 짧았다(p < 0.05). 위-복막간 유착은 군간 모든 개체에서 양호하게 형성되었으나 평균 유착 길이(AL)와 너비(AW)의 수치가 LG군에서 PEG군에 비해 유의하게 높았다 (p < 0.05). 평균 유착 거리(AD)는 군간 차이를 보이지 않았다(p = 0.182). 본 연구를 통해 개에서 LG는 최소 침습적이면서 쉽고 안전하게, 그리고 효과적으로 장관 영양 공급을 실시할 수 있는 방법임이 확인되었다.

Aim of this study is demonstrate the feasibility of Laparoscopic gastrostomy (LG) tube placement in dogs by comparing with percutaneous endoscopic gastrostomy (PEG) tube placement, based on operative time, complications and gastro-peritoneal adhesion evaluation. Eight intact male beagle dogs were used in this study. Tri-Funnel Replacement Gastrostomy tube (Bard Inc., USA) of 20 Fr was used for LG technique and PEG kit (Ponsky "Pull" PEG Kit$^{(R)}$, Bard Inc., USA) with soft silicone retention dome consisting of a 20 Fr gastrostomy tube was used. Feeding via gastrostomy tube was performed in two weeks, maintenance energy requirement (MER) divided into 3 separate feeding. LG and PEG were evaluated at intraoperative, postoperative and postmortem period. Mean operative time for the PEG group was significantly shorter when compared with the LG group (p < 0.05). Successful maintenance of gastrostomy tube was confirmed in all dogs. Gastric and peritoneal wall adhesions were formed successfully in each group. The mean adhesion length (AL) and width (AW) were significantly larger in LG group compared with in PEG group (p < 0.05). The mean adhesion distance (AD) was not significantly different between two groups (p = 0.182). Consequently, LG is an effective minimally invasive, safe and easy to perform technique for providing enteral nutritional support in dogs.

키워드

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