Use of the subcutaneous ureteral bypass device and urethral stenting for treatment of malignant urinary outflow tract obstructions in cats.

IF 1.9 2区 农林科学 Q2 VETERINARY SCIENCES
Mariel S Covo, Allyson C Berent, Chick W Weisse
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引用次数: 0

Abstract

Objectives: The aim of this study was to describe the technical success and outcomes of ureteral and urethral decompression using the subcutaneous ureteral bypass (SUB) device and transurethral self-expanding metallic stents (SEMS) as a palliative treatment option for feline malignant urinary outflow tract obstructions.

Methods: A retrospective study was conducted of 14 cats with ureteral and/or urethral obstructions secondary to diagnosed or suspected transitional cell carcinoma (TCC). In all cats, a SUB device and/or a SEMS was placed to relieve the obstruction(s). Group 1 consisted of cats with ureteral obstructions, with or without concurrent urethral obstructions, and group 2 consisted of cats with only urethral obstructions.

Results: Eight cats were included in group 1 (seven with concurrent urethral obstructions) and six cats were included in group 2. TCC was confirmed in 8/14 cats. Repeat urethral obstruction due to tumor in growth occurred in 6/13 (46%) cats with a SEMS, and no cats developed recurrent ureteral obstructions after placement of the SUB device. Three cats had additional covered stents placed after urethral re-obstruction. The median survival time (MST) from the time of device placement was 52 days in group 1 (mean 92; range 14-349) and 80 days in group 2 (mean 96; range 7-209). The MST from the time of mass identification of the cats that did and did not receive adjunctive therapy was 349 days (mean 358; range 124-602) and 43 days (mean 113; range 14-423), respectively.

Conclusions and relevance: The use of bypass devices for feline malignant urinary outflow tract obstructions is a viable option to provide immediate renal and urinary bladder decompression. TCC in cats is locally aggressive and can result in urethral re-obstruction, prompting consideration for placing a covered urethral stent. The use of adjunctive therapies for malignant neoplasia should be considered to improve overall survival once the obstruction has been relieved.

使用皮下输尿管旁路装置和尿道支架治疗猫的恶性尿流出道梗阻。
研究目的本研究旨在描述使用皮下输尿管旁路(SUB)装置和经尿道自膨胀金属支架(SEMS)进行输尿管和尿道减压的技术成功率和结果,作为猫科动物恶性尿流出道梗阻的姑息治疗方案:对 14 只因确诊或疑似过渡性细胞癌 (TCC) 而继发输尿管和/或尿道梗阻的猫进行了回顾性研究。所有猫都安置了 SUB 装置和/或 SEMS,以缓解梗阻。第 1 组包括输尿管梗阻的猫咪,无论是否同时存在尿道梗阻;第 2 组包括仅有尿道梗阻的猫咪:第 1 组包括 8 只猫咪(7 只同时患有尿道梗阻),第 2 组包括 6 只猫咪。6/13(46%)只安装了 SEMS 的猫因肿瘤生长而再次发生尿道梗阻,没有猫在安装 SUB 装置后再次发生输尿管梗阻。三只猫在尿道再次阻塞后又放置了有盖支架。第 1 组(平均 92 天;14-349 天不等)和第 2 组(平均 96 天;7-209 天不等)的中位存活时间(MST)分别为 52 天和 80 天。接受和未接受辅助治疗的猫咪从大规模鉴定时算起的MST分别为349天(平均358天;范围124-602天)和43天(平均113天;范围14-423天):使用旁路装置治疗猫恶性尿流出道梗阻是一种可行的选择,可立即为肾脏和膀胱减压。猫的 TCC 具有局部侵袭性,可导致尿道再次阻塞,因此应考虑放置有盖尿道支架。一旦梗阻得到缓解,应考虑使用恶性肿瘤辅助疗法来提高总体存活率。
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来源期刊
CiteScore
3.90
自引率
17.60%
发文量
254
审稿时长
8-16 weeks
期刊介绍: JFMS is an international, peer-reviewed journal aimed at both practitioners and researchers with an interest in the clinical veterinary healthcare of domestic cats. The journal is published monthly in two formats: ‘Classic’ editions containing high-quality original papers on all aspects of feline medicine and surgery, including basic research relevant to clinical practice; and dedicated ‘Clinical Practice’ editions primarily containing opinionated review articles providing state-of-the-art information for feline clinicians, along with other relevant articles such as consensus guidelines.
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