Complications in Equine Surgery - Группа авторов

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to include at least that margin in the freezing process. For ocular squamous cell carcinomas, a 2‐ to 3‐mm margin has been advised [5].

       Treatment

      The cryosurgical procedure can be repeated taking into account the above‐mentioned preventive measures. Several other tumor treatment modalities can be applied, such as (laser) excision, chemotherapy, topical treatments, and BCG vaccination.

       Expected outcome

      For equine sarcoids it should be kept in mind that recurrent tumors have been reported to have a lower response rate to further treatment modalities [4, 28], although this has not been confirmed in another study [7].

      1 1 Tate, L.P. and Evans, L.H. (1980). Cryoneurectomy in the horse. J. Am. Vet. Med. Assoc. 177: 423–426.

      2 2 McKibbin, L.S. and Paraschak, D.M. (1985). An investigation on the use of cryosurgery for treatment of bone spavin, splint and fractures splint bone injuries in Standardbred horses. Cryobiology. 22: 468–476.

      3 3 Klein, W.R., Bras, G.E., Misdorp, W. et al. (1986). Equine sarcoid BCG immunotherapy compared to cryosurgery in a prospective randomised trial. Canc. Immunol. Immunother. 21: 133–140.

      4 4 Martens, A., De Moor, A., Vlaminck, L. et al. (2001). Evaluation of excision, cryosurgery and local BCG vaccination for the treatment of equine sarcoids. 149: 665–669.

      5 5 Bosch, G. and Klein, W. (2005). Superficial keratectomy and cryosurgery as therapy for limbal neoplasms in 13 horses. Vet. Ophthal. 8: 241–246.

      6 6 Top, J.G.B., de Heer, N., Klein, W.R. et al. (2008). Penile and preputial squamous cell carcinoma in the horse: a retrospective study of treatment of 77 affected horses. Equine Vet. J. 40: 533–537.

      7 7 Haspeslagh, M., Vlaminck, L.E.M., and Martens, A.M. (2016). Treatment of equine sarcoids in equids: 230 cases (2008–2013). J.A.V.M.A. 249: 311–318.

      8 8 Giuliano, E.A. (2011). Equine ocular adnexal and nasolacrimal disease. In: Equine Ophthalmology, 2e (ed. B.C. Gilger), 152–153. Elsevier‐Saunders.

      9 9 Jung, C., Stumpf, G., Litzke, L. et al. (2008). Zur Konservativen Therapie der Urachusfistel beim Fohlen: Kryochirurgie versus Metakresolverödung. Pferdeheilkunde. 24: 554–564.

      10 10 Gage, A.A. and Baust, J.G. (1998). Mechanisms of tissue injury in cryosurgery. Cryobiology. 37: 171–186.

      11 11 Hoffmann, N.E. and Bischof, J.C. (2002). The cryobiology of cryosurgical injury. Urology. 60: 40–49.

      12 12 Robilotto, A.T., Baust, J.M., Van Buskirk, R.G. et al. (2013). Temperature‐dependent activation of differential apoptotic pathways during cryoablation in a human prostate cancer model. Prost. Canc. Prostat. Dis. 16: 41–49.

      13 13 Lane, J.G. (1977). The treatment of equine sarcoids by cryosurgery. Equine Vet. J. 9: 127–133.

      14 14 Fretz, P.B. and Barber S.M. (1980). Prospective analysis of cryosurgery as the sole treatment for equine sarcoids. Vet. Clin. N. Am. Small Anim. Pract. 10: 869–875.

      15 15 Fretz, P B. and Holmberg D.L. (1980). Sequelae to cryosurgery. Vet. Clin. N. Am. Small Anim. Pract. 10: 869–874.

      16 16 McConaghy, F.F., Davis, R.E., Reppas, G.P. et al. (1994). Management of equine sarcoids: 1975–1993. N.Z. Vet. J. 42: 180–184.

      17 17 Cooper, I.S. (1964). Cryobiology as viewed by the surgeon. Cryobiology. 1: 44–51.

      18 18 Baust J.G., Gage A.A., Bjerklund Johansen T.E. et al. (2014). Mechanisms of cryoablation: clinical consequences on malignant tumors. Cryobiology. 68: 1–11.

      19 19 Baust, J.G. and Gage, A.A. (2005). The molecular basis of cryosurgery. B.J.U. Int. 95: 1187–1191.

      20 20 Stick, J.A. (2012). Cryosurgery. In: Equine Surgery, 4e (ed. J.A. Auer and J.A. Stick), 161–165. Elsevier‐Saunders.

      21 21 Featherstone, H.J., Renwick, P., Heinrich, C. et al. (2009). Efficacy of lamellar resection, cryotherapy, and adjunctive grafting for the treatment of caning limbal melanoma. Vet. Ophthal. 12 (Supp. 1): 65–72.

      22 22 Nizamoglu, M., Tan, A., Vickers, T. et al. (2016). Cold burn injuries in the UK: the 11‐year experience of a tertiary burns centre. Burns Trauma. 4: 36.

      23 23 Marti, E., Lazary, S., Antczak, D.F. et al. (1993). Report of the first international workshop on equine sarcoid. Equine Vet. J. 25: 397–407.

      24 24 Richardson, D.W. and Ahern, B.J. (2012). Synovial and osseous infections. In: Equine Surgery, 4e (ed. J.A. Auer and K.A. Stick), 1190–1194. Elsevier‐Saunders.

      25 25 Knottenbelt, D.C. and Kelly, D.F. (2000). The diagnosis and treatment of periorbital sarcoid in the horse: 445 cases from 1974 to 1999. Vet. Ophthal. 3: 169–191.

      26 26 Martens, A., De Moor, A., and Ducatelle, R. (2001). PCR detection of bovine papilloma virus DNA in superficial swabs and scrapins from equine sarcoids. Vet. J. 161: 280–286.

      27 27 Martens, A., De Moor, A., Demeulemeester, J. et al. (2001). PCR analysis of the surgical margins of equine sarcoids for bovine papilloma virus DNA. Vet. Surg. 30: 460–467.

      28 28 Bergvall, K.E. (2013). Sarcoids. Vet. Clin. Equine. 29: 657–671.

       Kenneth E. Sullins DVM, MS, DACVS

       College of Veterinary Medicine, Midwestern University, Glendale, Arizona

      LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. Excitation of a contained medium (for which the laser is often named) produces coherent electromagnetic radiation, light. A coherent beam remains intact almost indefinitely instead of diverging and can be manipulated by lenses. Lasers are typically monochromatic (a single wavelength or “color”), which determines their specific tissue interaction [1].

      Lasers expand surgical capabilities by facilitating minimally invasive surgery and reaching areas that would otherwise be completely inaccessible or by interacting with tissue in ways impossible with conventional instruments. Procedures previously requiring hospitalization, general anesthesia and prolonged convalescence may be accomplished in an outpatient visit. However, lasers may not be the most appropriate method for some procedures and the “fit” should not be forced. Surgical complications are minimized by a thorough understanding of anatomy, tissue response to injury, and surgical experience. Lasers add a substantial layer to each of these considerations. Mastering basic laser physics is required for safe and effective application of surgical lasers. All too commonly, surgical lasers are taken up as an experiment or “on the job” experience is used to develop technique [2].

       Laser physics and tissue interaction

       Lasers commonly used in veterinary surgery

       Carbon Dioxide Laser

       Neodymium Yttrium Aluminum Garnet (Nd:YAG) Laser

       Gallium Aluminum Arsenide (GAA) Diode Laser

       Laser safety

       Specific complications of laser surgery in horses

       Patient Complications

       General surgery

       Endoscopic Laser Surgery

       Tarsal arthrodesis complications

       Equipment Complications

       Summary

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