Weisse Chick, Berent Allyson, Todd Kim, Clifford Craig, Solomon Jeffrey
Section of Small Animal Surgery, Department of Clinical Studies-Philadelphia, University of Pennsylvania, 19104-6010, USA.
J Am Vet Med Assoc. 2006 Jul 15;229(2):226-34. doi: 10.2460/javma.229.2.226.
To evaluate use of balloon-expandable and self-expanding metallic stents in management of malignant urethral obstructions in dogs.
Original study.
12 dogs with malignant urethral obstructions.
The extent and location of urethral obstructions and the diameter of adjacent unaffected luminal segments were determined by use of fluoroscopically guided wires and measuring catheters. Stents were chosen to extend approximately 1 cm proximal and distal to the obstruction. Stent diameters were chosen to be approximately 10% greater than the diameter of healthy portions of the urethra to prevent displacement. Stents were placed in the urethra under fluoroscopic guidance to restore luminal patency.
3 dogs received balloon-expandable metallic stents, and 9 dogs received self-expanding metallic stents. The placement procedures were rapid, safe, and effective at restoring luminal patency and were not associated with major complications. Complications included recurrent urethral obstruction secondary to blood clot formation and urethral edema in 1 dog and stent dislodgement into the urinary bladder in 1 dog. All dogs were able to urinate immediately after the procedure. Nine dogs (3/4 females and 6/8 males) were continent or mildly incontinent after stent placement. Of the remaining 3 dogs, 2 developed severe incontinence and 1 had an atonic bladder. Seven dogs were considered to have good to excellent outcome, 3 had fair outcome, and 2 had poor outcome.
Transurethral placement of metallic stents was a safe and effective palliative treatment option for dogs with malignant urethral obstructions.
评估球囊扩张式和自膨式金属支架在犬恶性尿道梗阻治疗中的应用。
原创性研究。
12只患有恶性尿道梗阻的犬。
使用荧光透视引导钢丝和测量导管确定尿道梗阻的范围、位置以及相邻未受影响管腔段的直径。选择的支架在梗阻近端和远端各延伸约1 cm。选择的支架直径比尿道健康部分的直径大约大10%,以防止移位。在荧光透视引导下将支架置入尿道以恢复管腔通畅。
3只犬接受了球囊扩张式金属支架,9只犬接受了自膨式金属支架。置入操作迅速、安全且有效地恢复了管腔通畅,未出现严重并发症。并发症包括1只犬因血凝块形成和尿道水肿继发复发性尿道梗阻,以及1只犬的支架移位至膀胱。所有犬在手术后立即能够排尿。9只犬(3/4雌性和6/8雄性)在支架置入后能自主排尿或轻度尿失禁。其余3只犬中,2只出现严重尿失禁,1只出现无张力膀胱。7只犬被认为预后良好至极佳,3只预后一般,2只预后较差。
经尿道置入金属支架是治疗犬恶性尿道梗阻的一种安全有效的姑息治疗选择。