开放手术或膀胱镜引导下激光消融治疗25只雌性犬异位输尿管的疗效。

B. Dekerle, E. Maurice, A. Decambron, V. Viateau, C. Maurey, M. Manassero
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引用次数: 4

摘要

目的报道开放手术或膀胱镜引导下激光消融(CLA)治疗犬异位输尿管的疗效。研究设计:2011 - 2018年回顾性研究。动物:25只母狗。方法收集的数据包括信号、临床病理资料、手术资料、并发症、近期和长期结果。如果需要手术修复,并发症分为轻微或严重。对尿失禁状况进行主观评分(1 =完全尿失禁至10 =完全尿失禁)。结果15只犬有双边EU, 24只犬有内部EU。开放手术矫正包括13例神经输尿管造口术,2例新膀胱输尿管造口术,以及2只狗的这些手术组合。8只狗接受了CLA。18只狗出现轻微并发症(72%),2只狗出现严重并发症(8%)。20/25(80%)只狗术后1个月尿失禁(中位得分为10分)。5只狗在24.9个月的中位时间内尿失禁复发,但对药物治疗有反应。总的来说,狗保持尿失禁66个月(中位数),22/25(88%)的狗在尿失禁的同时进行了药物/手术治疗。与神经输尿管造口术相比,CLA术后的轻微并发症和术后尿失禁复发较少(P < 0.05)。0.01和P < 0.05)。结论采用开放手术或CLA进行异位输尿管矫正,主观上预后良好,大多数犬在手术后一个月内达到尿失禁,尽管长期尿失禁偶尔会复发。与神经输尿管造口术相比,CLA的并发症和尿失禁复发较少。临床意义膀胱镜引导下的激光消融术矫正尿失禁,可预防近期并发症及尿失禁复发。进一步的研究应探讨尿失禁术后复发的原因。
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Outcomes of 25 female dogs treated for ectopic ureters by open surgery or cystoscopic-guided laser ablation.
OBJECTIVE To report outcomes after the correction of ectopic ureter (EU) by open surgery or cystoscopic-guided laser ablation (CLA) in female dogs. STUDY DESIGN Retrospective study from 2011 to 2018. ANIMALS Twenty-five female dogs. METHODS Data collected included signalment, clinicopathologic data, procedural data, complications, and short-term and long-term outcomes. Complications were graded as minor or major if a surgical revision was required. Continence status was scored subjectively (1 = completely incontinent to 10 = fully continent). RESULTS Fifteen dogs had bilateral EU and 24 had intramural EU (iEU). Open surgical correction included 13 neoureterostomies, 2 neocystoureterostomies, and a combination of these in 2 dogs. Eight dogs underwent CLA. Eighteen dogs experienced minor complications (72%), and 2 experienced major complications (8%). One-month postoperative continence was achieved in 20/25 (80%) dogs (median score of 10). Incontinence recurred at a median time of 24.9 months in 5 dogs but responded to medical treatment. Overall, dogs remained continent for 66 months (median) and 22/25 (88%) dogs achieved continence with adjunction of medical/surgical treatment in incontinent ones. Fewer minor complications and postoperative recurrences of incontinence were documented after CLA than neoureterostomy (P < .01 and P < .05). CONCLUSION Ectopic ureter correction by open surgery or CLA resulted in a subjectively good prognosis, most dogs reaching continence within a month of surgery, although incontinence occasionally recurred in the long term. CLA was associated with fewer complications and incontinence recurrences than neoureterostomy. CLINICAL SIGNIFICANCE Cystoscopic-guided laser ablation should be preferred to correct iEU to prevent short-term complications and the recurrence of incontinence. Further studies should investigate the cause of postoperative recurrence of urinary incontinence.
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