在八只狗身上进行皮肤肥大细胞瘤手术切除后的原发性阴茎前庭重建,无需截除阴茎。

IF 1.1 4区 农林科学 Q3 VETERINARY SCIENCES
New Zealand veterinary journal Pub Date : 2024-05-01 Epub Date: 2024-02-07 DOI:10.1080/00480169.2024.2308807
R Hammerton, M Goodfellow, S Das
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引用次数: 0

摘要

病史:对一家转诊医院(英国希钦市戴维斯兽医专科医院)的医疗记录进行了审查,以确定2017年6月至2022年6月期间患有阴茎前皮肤肥大细胞瘤(CMCT)的犬只(n = 8),这些犬只在客户拒绝阴茎截肢和尿道造口术等替代方案后,接受了手术切除和初级阴茎前重建术,保留了阴茎和尿道:肿瘤的中位直径为 21.5 毫米(最小 15 毫米,最大 30 毫米),相对于包皮位于颅内(3/8)、颅尾(1/8)、侧方(2/8)和背侧(2/8),根据细胞学诊断为 CMCT。在细胞学检查中,没有犬只出现肝脏或脾脏转移,但在3/4的取样犬只中发现了腹股沟淋巴结转移:所有狗的主人都拒绝了阴茎截肢和阴囊尿道造口术。手术切除了CMCT,并对包皮进行了初次重建。手术侧缘为 10、20 或 30 毫米,深缘切除包皮内层或下层肌肉筋膜。尾腹侧包皮环切术的深部边缘涉及切除下层包皮脂肪组织。3/8只犬进行了阴茎前庭推进术,以实现充分的阴茎覆盖。组织病理学证实所有 CMCT 均为 Kiupel 低分级,6/8 的狗为 Patnaik II 级,边缘完整,但只在一只狗的一个腹股沟淋巴结中发现了转移灶。两只狗出现了轻微并发症(感染和轻微开裂),一只狗出现了严重并发症(感染和严重开裂)。中位随访时间为 125 周,其中一只狗的随访时间仅为 4 周。在现有的随访期内,没有一只狗出现局部复发或死于肥大细胞病:这项临床研究评估了一种替代阴茎截除术和先进重建技术的手术方法,用于治疗Kuipel低/Patnaik II级阴茎癌前病变,而这些手术都遭到了狗主人的拒绝。在无法选择阴茎截肢和阴囊尿道造口术的情况下,可通过手术切除阴茎前CMCT,手术侧缘为10、20或30毫米,并进行初级阴茎前重建,且发病率低、疗效好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary preputial reconstruction following surgical excision of cutaneous mast cell tumours without penile amputation in eight dogs.

Case history: Medical records from a single referral hospital (Davies Veterinary Specialists, Hitchin, UK) were reviewed to identify dogs (n = 8) with preputial cutaneous mast cell tumours (CMCT) that underwent surgical excision and primary preputial reconstruction, preserving the penis and urethra, after clients declined alternatives such as penile amputation and urethrostomy, from June 2017-June 2022.

Clinical findings: Tumours had a median diameter of 21.5 (min 15, max 30) mm, were located cranioventrally (3/8), caudoventrally (1/8), laterally (2/8) and dorsally (2/8) relative to the prepuce and were diagnosed as CMCT based on cytology. No dogs had hepatic or splenic metastasis on cytology but inguinal lymph node metastasis was identified in 3/4 dogs sampled.

Treatment and outcome: The owners of all dogs had declined penile amputation and scrotal urethrostomy. The CMCT were excised and primary reconstruction of the prepuce performed. Surgical lateral margins of 10, 20 or 30 mm were used and the deep margin excised the inner preputial lamina or underlying muscular fascia. The deep margin for caudoventral CMCT involved excision of the underlying SC adipose tissue. Preputial advancement was performed in 3/8 dogs to achieve adequate penile coverage. Histopathology confirmed all CMCT were Kiupel low grade, Patnaik grade II with complete margins in 6/8 dogs but identified metastasis only in one inguinal lymph node from one dog. Two dogs encountered minor complications (infection and a minor dehiscence) and one dog had a major complication (infection with major dehiscence). Median follow-up duration was 125 weeks, excluding one dog with 4 weeks of follow-up. None of the dogs experienced local recurrence or died of mast cell disease during the available follow-up period.

Clinical relevance:  This clinical study evaluated a surgical alternative to penile amputation and advanced reconstructive techniques for Kuipel low/Patnaik grade II preputial CMCT when these procedures were declined by owners. Surgical excision of preputial CMCT with lateral margins of 10, 20 or 30 mm with primary preputial reconstruction is achievable with low morbidity and a good outcome when penile amputation and scrotal urethrostomy is not an option.

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来源期刊
New Zealand veterinary journal
New Zealand veterinary journal 农林科学-兽医学
CiteScore
3.00
自引率
0.00%
发文量
37
审稿时长
12-24 weeks
期刊介绍: The New Zealand Veterinary Journal (NZVJ) is an international journal publishing high quality peer-reviewed articles covering all aspects of veterinary science, including clinical practice, animal welfare and animal health. The NZVJ publishes original research findings, clinical communications (including novel case reports and case series), rapid communications, correspondence and review articles, originating from New Zealand and internationally. Topics should be relevant to, but not limited to, New Zealand veterinary and animal science communities, and include the disciplines of infectious disease, medicine, surgery and the health, management and welfare of production and companion animals, horses and New Zealand wildlife. All submissions are expected to meet the highest ethical and welfare standards, as detailed in the Journal’s instructions for authors.
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