Evaluation of the efficacy of diaphragmatic and omental transplants at the gastroesophageal junction in dogs
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Date
1998
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Department of Surgery, College of Veterinary and Animal Sciences, Mannuthy
Abstract
The study was undertaken with the objectives of designing
a surgical approach to the gastroesophageal region in dogs and
to evaluate the efficacy of diaphragmatic and omental grafting
at the gastroesophageal myotomy site.
The study was conducted in 30 adult dogs of either sex
divided into five groups of six animals each.
The animals were premedicated with atropine sulphace
(0.04 mg/kg body weight) and xylazine (0.5 mg/kg body weight)
IM. Anaesthesia was induced and maintained with five per cent
solution of thiopentone sodium to effect. Induction of
anaesthesia and recovery was smooth and uneventful and the
duration was satisfactory. Respiratory arrest observed in a
few animals could be corrected except in one and respiration
was maintained with respiration pump or Boyles' Tec
anaesthetic apparatus.
Gastroesophageal myotomy was performed through left side
thoracotomy with resection of eighth rib in animals of Group
I and by laparotomy, through the 12th intercostal space with
resection of 12th rib in animals of Group 11, to study the
suitability of surgical approaches.
Abdominal approach adopted in Group II was found suitable
for experimental approach and was adopted in animals of
Groups III, IV and V. In the animals of Groups III, IV and V
gastroesophageal myotomy was performed and the myotomy
edges were sutured to the overlying portion of diaphragm in
Group III, to a deflected portion of diaphragmatic pedicle
graft in Group IV and to a deflected portion of omental
pedicle graft in Group V.
The animals were kept under observation for 21 days post
operatively and observed for physiological changes, clinical
signs, haematologic, radiographic and electrocardiogram
changes. Physiological parameters showed a significant
decrease in rectal temperature upto 90th min after surgery and
significant increase in pulse and respiration rate upto 24 h.
All the animals were alert and active throughout the period of
observation. Feed intake and swallowing was normal. Skin
wound had healed without complications in all the animals.
Haemogram showed normal haemoglobin concentration,
erythrocyte sedimentation rate and packed cell volume
throughout the period of observation in all the animals.
Erythrocyte count was within normal range in all the animals
except for a transient decrease in Group I and leucocyte count
showed an increase in Group V. An increase in neutrophil
count was observed on the 7th and 14th day in Groups III and
V with a corresponding decrease in lymphocyte count. Monocyte
count was normal in all the animals and oesinophil count
showed a decrease in Group I. The values returned to normal
range by 21st day in all the animals.
The electrocardiogram changes observed during surgery and
in post operative period were spontaneously corrected.
Contrast radiography of the oesophagus and stomach
revealed normal emptying and absence of leakage. Narrowing' of
the caudal end of thoracic oesophagus along with dilatation of
the stomach was observed in one animal and dilatation of
stomach alone was
observed in two animals.
Contrast
radiography of the autopsy specimen of oesophagus and stomach
of one animal each from Group I and 11 revealed increased
width of gastroesophageal region and an outpouching of the
stomach at the greater curvature.
Gross morphological examination on autopsy in Group I
revealed adhesion of lung with thoracic wall, diaphragm and
oesophagus, congestion and consolidation of lung, collapse of
the lung lobes and mediastinial pleuritis in a few animals.
Fibrous tissue covering over the caudal end of thoracic
oesophagus was also seen in two animals.
Adhesion of omentum with abdominal wall and diaphragm was
the autopsy changes noticed in Group 11.
Oesophagus was normal in size in all the animals except
in one animal where slight narrowing at the caudal end was
observed. Increased width at the gastroesophageal region was
evident in all the animals.
An outpouching at the greater
curvature of the stomach was seen in all animals except three
where slight dilation and flaccidity of the stomach was
noticed. The myotomy site was thin in Groups I, II and V. In
Groups III, the portion of diaphragm sutured to the myotomy
wound was firmly adherent with it and in Group IV, the
diaphragm pedicle graft sutured to the myotomy wound has
healed and was firmly adherent to the myotomy site.
In Group V, the omental pedicle graft sutured to the myotomy site has healed completely and was indistinguishable.
On histological examination no sign of inflammation was
noticed in the mucosa and submucosa.
.
At the myotomy site
fibrovascular connective tissue proliferation was observed in
all the groups.
In Groups III and IV peripheral to the
fibrovascular connective tissue,the fascicles of
diaphragmatic muscle fibrils were observed.
In Group V beneath the thin fibrovascular layer
infiltration of plasma cells, lymphocytes, macrophages and a
few neutrophils were observed extending into the stroma and
lamina propria.
A layer of fibrous connective tissue was
observed as the outermost layer over the thin fibrovascular
layer and contained a few fat cells in one animal.
Description
PhD
Keywords
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Citation
171381