Biomedical subjects

D L Holmberg

Publications and source records attributed to D L Holmberg.

9 recordsLinked to original sources

PubMed1991

Free bowel transfer for esophageal reconstruction in the dog.

Clinical esophageal reconstruction in dogs is generally limited to the repair of small segments of cervical and terminal thoracic esophagus. The attempt was made to develop a procedure for the replacement of the entire thoracic esophagus. Three groups of dogs were used for microvascular colon transfers. Five dogs received orthotopic colon autografts. A segment of cervical esophagus was replaced in three dogs, and the entire thoracic esophagus was bypassed in six dogs. The orthotopic grafts worked well and the surviving dogs had normal stools within 48 hr of surgery. The cervical grafts all remained viable, and dogs were able to drink normally and swallow gruel from elevated bowls. Chronic regurgitation of solid food due to inadequate graft motility was an unresolved problem. All thoracic esophageal bypass grafts failed because of mechanical kinking of the vascular pedicles and leakage.

Anastomosis, Surgical↗

PubMed1990

Facial reconstruction.

Reconstruction of the facial and mandibular areas has received little attention in small animal surgery. Defects requiring reconstruction are often the result of trauma or neoplasia. This chapter explores problems of the maxillary, nasal, and mandibular areas, and describes recent surgical advancements that have application in these cases.

Animals↗

PubMed1979

Management of pyothorax.

Pyothorax is a serious disease process which requires both medical and surgical intervention. Late recognition, management problems, and likely recurrence make successful treatment difficult and often frustrating. Aims of therapy should be to avoid undue stress to the patient, to relieve respiratory distress by thoracocentesis, to eliminate infectious agents with antimicrobials, to remove pleural exudate, and to provide supportive care. Close monitoring of the patient is necessary to prevent iatrogenic complications such as pneumothorax, hemothorax, hypothermia, or hypoproteinemia. Exploratory thoracotomy for removal of granulomatous material and fibroelastic pleural "peels" is occasionally necessary to resolve compressive cardiopulmonary lesions.

Animals↗

PubMed1979

Vascular ring anomalies: case report and brief review.

During early fetal life six pair of aortic arches surround the esophagus and trachea. Normal maturation and selective regression of these structures form the adult vasculature. Abnormal location or development of the aortic arches may result in pressure on adjacent organs. Vascular ring anomalies must be considered with any patient with a history of regurgitating food shortly after eating. Physical examination, test feedings, survey and contrast radiographs may give an accurate impression of the problem but a final diagnosis can only be made following surgical exploration. In the case presented, the dog had all the clinical and diagnostic signs suggestive of a vascular ring anomaly. Thoracotomy and elimination of the vascular constriction around the esophagus was both diagnostic and therapeutic for the condition. It is important that owners be made aware that surgical correction of the stenosis does not guarantee a successful conclusion to the case. If the dilation of the esophagus cranial to the stenosis is severe, accumulation of food with subsequent regurgitation may persist. A dilation of the esophagus caudal to the stenosis is present in a large percentage of cases and this also may result in an unrelenting problem. Unfortunately, the probability of these complications cannot be accurately evaluated prior to treatment.The hereditary potential for this defect must also be considered. Congenital vascular anomalies such as patent ductus arteriosus would seem to have a hereditary basis. Therefore, it is probably correct to advise against breeding affected animals. Further, the inbreeding of nonaffected animals which come from litters containing affected animals should be avoided.

Animals↗

PubMed1978

Prophylactic use of antibiotics in surgery.

"Sound and careful surgery is the sine qua non of wound management; antimicrobials are adjunctive." The key to successful use of prophylactic antibiotics in surgery is careful selection of cases and medication. There are no final rule or formulas that will always give optimal results. Listed below are some guidelines that may assis the clinician in determining the need and form of antimicrobial use. 1. The operation must carry a significant risk of bacterial contamination. Refined-clean and clean procedures should not be given prophylactic antibiotics. 2. Bacterial cultures should be taken when possible, and the medication used for prophylaxis should be effective against the organisms expected to be encountered. 3. Narrow spectrum antibiotics should be used to conserve the body's normal flora. Broad spectrum antibiotics needed to combat resistant infections should not be used for prophylaxis. 4. The antibiotic should be present in the wound in effective concentrations at the time of the incision and be maintained only as long as the risk of new bacterial contamination exists.

Anti-Bacterial Agents↗

PubMedDate not supplied

Esophageal replacement in the dog by microvascular colon transfer.

An orthotopic colon graft based on the middle colic artery and vein was implanted with microvascular technique and a stapling instrument in five dogs. The grafts were successful in four dogs. A similar colon autograft was used to replace the entire thoracic esophagus in five dogs. The recipient vessels were the left carotid artery and left external jugular vein. Four of the grafts failed because of kinking and thrombosis of the arterial supply (2 dogs) or the venous outflow (2 dogs). One graft, which had a viable vascular supply, developed a severe leak at the colon-to-stomach anastomosis, and the dog was euthanatized on day 3. The recipient vascular pedicle was modified and used successfully to replace a portion of the cervical esophagus in three dogs. The grafts survived, the dogs could swallow liquids and semisolid food well, and, at necropsy after 4 weeks, the anastomotic sites were well healed. The graft sites contained essentially normal colon mucosa.

Anastomosis, Surgical↗

PubMedDate not supplied

Ventral rhinotomy in the dog and cat.

The nasal cavities of 14 dogs and three cats were explored surgically using a ventral rhinotomy. The exposure achieved through this approach was considered to be equal to a dorsal rhinotomy. One animal died during the immediate postoperative period from perforation of a gastric ulcer. The other animals recovered well and had no significant complications. The long-term survival of the animals was consistent with previous reports for their diseases. Ventral rhinotomy is no more difficult than dorsal rhinotomy, has less patient morbidity and fewer postoperative complications, and is more cosmetically acceptable.

Animals↗

PubMedDate not supplied

A comparison of manual and power-assisted thoracolumbar disc fenestration in dogs.

Thoracolumbar disc fenestration was performed in eight canine cadavers. A hole was cut in the anulus fibrosus with a scalpel in four dogs, and with a high speed drill and burr in four dogs. A curette was used to remove as much of the nucleus pulposus as possible. Sixty-five percent of the nucleus pulposus was removed with the power-assisted technique and 41% was removed by manual fenestration. Manual and power-assisted disc fenestration were performed on alternate intervertebral discs from T11-12 to L5-6 in four dogs. Six months after surgery, results of high-detail radiographic and histologic evaluation of the vertebral bodies and discs showed minimal difference in the sequelae of the two techniques. A retrospective medical records analysis and follow-up of 60 clinical cases treated with prophylactic, power-assisted disc fenestration failed to identify any cases with postoperative recurrence of neurologic deficits. Ten percent of the dogs had periodic back pain of unknown etiology, without other signs of intervertebral disc disease. The findings of this study indicate that power-assisted disc fenestration permits more complete evacuation of the nucleus than manual fenestration, causes no more postoperative complications, and results in a low recurrence rate of neurologic deficits.

Animals↗

PubMedDate not supplied

Enterocystoplasty with cystectomy and subtotal intracapsular prostatectomy in the male dog.

Urinary diversion by implantation of the ureters into an isolated segment of jejunum was evaluated in eight clinically normal male dogs. Total cystectomy and subtotal intracapsular prostatectomy were performed, and the intestinal loop was sutured to the prostatic remnant. General health, renal function, acid-base balance, urinary tract infection, and urinary continence were monitored during observation periods of 4 to 30 weeks. All dogs survived the observation period and seven were in excellent general health at the time of euthanasia. Six of the 16 ureterointestinal anastomoses were complicated by complete ureteral obstruction. Absorption of urea from the intestinal loop was speculated as the reason for significant increases in serum urea nitrogen concentrations in all of the dogs. Serum creatinine concentrations generally remained within the normal range, but were significantly increased from preoperative baseline values by week 30. There was dilation of 12 renal pelves and ureters in seven dogs. Urine bacterial cultures were positive in six dogs, but histologic evidence of pyelonephritis was present in only five kidneys. Ejaculation was not affected by the procedure, but epididymitis was present in five dogs. The dogs could urinate consciously and did not dribble urine continuously; however, they urinated hourly. While the procedure was well tolerated by the dogs, the frequency of urination makes this technique unacceptable for most household pets.

Anastomosis, Surgical↗