Mullen et al: A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health
Veterinary Surgery 4, 2023

🔍 Key Findings

Microvascular density at the site of foreign body obstruction was significantly lower in obstructed dogs compared to healthy controls.
PBR (perfused boundary region) was paradoxically lower in obstructed dogs, indicating that PBR may not reliably correlate with tissue viability in this context.
No significant difference in microvascular perfusion between subjectively viable vs nonviable intestines, suggesting subjective assessment is unreliable.
No difference in perfusion parameters between handsewn and stapled enterectomies, indicating both techniques preserve vascular health equally.
Stapled enterectomy using green TA staples is safe and did not impair intestinal perfusion at the anastomosis site.
SDF videomicroscopy is feasible intraoperatively and can differentiate healthy from diseased intestine in dogs.
Surgeons' subjective evaluations led to potentially unnecessary enterectomies, as microvascular parameters did not differ.
No cases of dehiscence or mortality, suggesting both surgical approaches are effective when applied properly.

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Mullen et al: A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health
Veterinary Surgery 4, 2023

🔍 Key Findings

Microvascular density at the site of foreign body obstruction was significantly lower in obstructed dogs compared to healthy controls.
PBR (perfused boundary region) was paradoxically lower in obstructed dogs, indicating that PBR may not reliably correlate with tissue viability in this context.
No significant difference in microvascular perfusion between subjectively viable vs nonviable intestines, suggesting subjective assessment is unreliable.
No difference in perfusion parameters between handsewn and stapled enterectomies, indicating both techniques preserve vascular health equally.
Stapled enterectomy using green TA staples is safe and did not impair intestinal perfusion at the anastomosis site.
SDF videomicroscopy is feasible intraoperatively and can differentiate healthy from diseased intestine in dogs.
Surgeons' subjective evaluations led to potentially unnecessary enterectomies, as microvascular parameters did not differ.
No cases of dehiscence or mortality, suggesting both surgical approaches are effective when applied properly.

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Multiple Choice Questions on this study

In Mullen 2023 et al., on microvascular perfusion, which metric differed significantly between obstructed and healthy intestines?

A. PBR for 5–9 µm vessels

B. PBR for all vessel sizes

C. Subjective viability score

D. Microvascular density

E. PBR for 10–19 µm vessels

Answer: Microvascular density

Explanation: Microvascular density was significantly lower in obstructed intestines compared to controls (p < .01), making it a reliable indicator.

In Mullen 2023 et al., on microvascular perfusion, what was the main advantage of sidestream dark field (SDF) videomicroscopy in assessing intestinal viability?

A. It reduced the need for postoperative imaging

B. It directly visualized the muscularis layer of the intestine

C. It objectively quantified microvascular perfusion and endothelial glycocalyx

D. It allowed for rapid histopathologic diagnosis intraoperatively

E. It facilitated staple line sealing via thermal imaging

Answer: It objectively quantified microvascular perfusion and endothelial glycocalyx

Explanation: SDF videomicroscopy allowed direct intraoperative assessment of perfusion using vessel density and PBR measurements.

In Mullen 2023 et al., on microvascular perfusion, what conclusion was drawn about handsewn versus stapled enterectomies?

A. Stapled enterectomies had higher PBR values

B. Handsewn techniques showed superior perfusion

C. Stapled enterectomies caused more vascular damage

D. No significant difference in perfusion metrics was observed

E. Stapled enterectomies were more likely to dehisce

Answer: No significant difference in perfusion metrics was observed

Explanation: Microvascular density and PBR adjacent to the suture or staple line did not significantly differ between techniques.

In Mullen 2023 et al., on microvascular perfusion, why was the green TA (4.8 mm) cartridge selected for stapled enterectomies?

A. It was the only size available

B. It provides better resistance to dehiscence

C. It matches canine intestinal thickness more closely

D. It reduces thermal spread

E. It improves mucosal healing

Answer: It matches canine intestinal thickness more closely

Explanation: The green TA cartridge matched canine small intestinal thickness (approx. 2.5 mm), supporting its appropriate use.

In Mullen 2023 et al., on microvascular perfusion, which of the following statements best reflects the accuracy of subjective assessment of intestinal viability?

A. It correlated well with microvascular parameters

B. It reliably distinguished viable from nonviable tissue

C. Surgeon assessment had over 90% specificity

D. It poorly predicted viability and often led to unnecessary resections

E. It eliminated the need for intraoperative imaging

Answer: It poorly predicted viability and often led to unnecessary resections

Explanation: Surgeon’s subjective assessment was shown to be unreliable, with no difference in microvascular density between subjectively viable and nonviable intestines.

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