背景:去势是驯化马术中最常见的外科手术;所使用的手术技术和围手术期处理差异很大。
目的:确定和绘制关于在驯化马术中与不同手术去势方法相关的围手术期并发症的现有证据。
方法:乔安娜·布里格斯研究所系统范围审查。
方法:CAB摘要,使用与马去势并发症相关的术语搜索Medline和Embase数据库。两位作者根据资格标准独立和盲目地筛选出版物。研究方法的数据,围手术期管理,外科技术,并提取围手术期并发症。手术技术根据技术分为几类;开放,关闭或半关闭,以及手术结束时顶骨外皮是开放还是闭合。
结果:搜索确定了1871篇出版物;71篇研究符合最终纳入标准。数据报告了76734次阉割,其中大部分是开放或封闭的,手术结束时阴道外衣保持开放。25项研究报告了有关外科技术和围手术期管理的信息,允许详细的图表和比较,其中镇痛和抗菌药物的使用差异显著。报告了18种不同的并发症,肿胀或水肿是最常见的。内脏损伤最常见于早期品种和标准品种,如果在手术结束时关闭顶骨外皮,风险似乎很低。
结论:不包括英文的灰色文献和研究。现有的研究在围手术期管理方面差异很大,手术技术和结果报告,使证据整合有问题。
结论:缺乏关于并发症定义的共识会导致不同外科技术和围手术期处理相关并发症发生率之间的不确定性和差异。建议在未来的研究中实施用于描述手术技术和并发症的标准化系统。许多研究未遵循当前建议的围手术期镇痛和使用抗菌药物。
BACKGROUND: Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably.
OBJECTIVE: To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids.
METHODS: Joanna Briggs Institute systematic scoping
review.
METHODS: CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study methods, perioperative management, surgical techniques, and perioperative complications were extracted. Surgical techniques were grouped into categories depending on technique; open, closed or half-closed, and whether the parietal tunic was open or closed at the end of surgery.
RESULTS: The search identified 1871 publications; 71 studies met the final inclusion criteria. The data reported 76 734 castrations, most of which were open or closed, with the vaginal tunic remaining open at the end of surgery. Twenty-five studies reported information regarding surgical techniques and perioperative management, allowing detailed charting and comparisons, of which analgesia and antimicrobial usage varied notably. Eighteen different complications were reported, with swelling or oedema being the most common. Evisceration was most commonly reported in draught breeds and Standardbreds, and the risk appeared low if the parietal tunic was closed at the end of surgery.
CONCLUSIONS: Grey literature and studies not available in English were not included. Existing studies varied greatly in perioperative management, surgical techniques and reporting of outcomes, making evidence consolidation problematic.
CONCLUSIONS: A lack of consensus regarding complication definitions creates uncertainty and discrepancies between complication rates associated with different surgical techniques and perioperative management. The implementation of standardised systems for describing surgical techniques and complications is recommended for future studies. A number of studies did not follow current recommendations for perioperative analgesia and use of antimicrobials.