激光碎石术用于犬膀胱结石和尿道结石碎石以利于取出的疗效及安全性

Efficacy and safety of laser lithotripsy in fragmentation of urocystoliths and urethroliths for removal in dogs.

作者信息

Lulich Jody P, Osborne Carl A, Albasan Hasan, Monga Manoj, Bevan John M

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.

出版信息

J Am Vet Med Assoc. 2009 May 15;234(10):1279-85. doi: 10.2460/javma.234.10.1279.

DOI:10.2460/javma.234.10.1279

PMID:19442022

Abstract

OBJECTIVE

To characterize the efficacy and safety of laser lithotripsy in the fragmentation of urocystoliths and urethroliths for removal in dogs.

DESIGN

Prospective case series.

ANIMALS

100 dogs with naturally occurring urocystoliths and urethroliths.

PROCEDURES

Via cystoscopy, laser lithotripsy was performed to fragment uroliths. Basket retrieval and voiding urohydropropulsion were used to remove fragments. Postprocedural contrast cystography was performed to assess efficacy and safety. In 40 dogs, midstream urine samples were collected just prior to laser lithotripsy (day 0) and on days 1, 3, and 11 after laser lithotripsy to assess inflammation.

RESULTS

Urolith removal was complete in 82% of dogs (52/66 with only urocystoliths, 17/17 with only urethroliths, and 13/17 with urocystoliths and urethroliths). Urolith removal was incomplete in 18 dogs; of these dogs, 9, 6, and 3 had urolith fragments >or= 3 mm, 1 to < 3 mm, and < 1 mm in diameter, respectively. Sex (female) was the most significant predictor for success. Median procedure time was 72 minutes. Two dogs developed urinary tract obstruction following laser lithotripsy. Hematuria was detected in 53% of dogs on day 0 and in 84%, 13%, and 3% of dogs on days 1, 3, and 11, respectively. Leukocyturia was detected in 13% of dogs on day 0 and in 47%, 0%, and 3% of dogs on days 1, 3, and 11, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that use of laser lithotripsy was a safe and effective alternative to surgical removal of urocystoliths and urethroliths in dogs.

摘要

目的

描述激光碎石术在犬膀胱结石和尿道结石破碎以利于取出过程中的疗效和安全性。

设计

前瞻性病例系列。

动物

100只患有自然发生的膀胱结石和尿道结石的犬。

方法

通过膀胱镜检查，进行激光碎石术以使尿路结石破碎。使用网篮取出和排尿性尿路水推进法来清除碎片。术后进行膀胱造影以评估疗效和安全性。在40只犬中，在激光碎石术前（第0天）以及激光碎石术后第1、3和11天收集中段尿样本以评估炎症。

结果

82%的犬（仅患有膀胱结石的66只中的52只，仅患有尿道结石的17只中的17只，同时患有膀胱结石和尿道结石的17只中的13只）尿路结石清除完全。18只犬的尿路结石清除不完全；在这些犬中，分别有9只、6只和3只犬的尿路结石碎片直径≥3毫米、1至<3毫米和<1毫米。性别（雌性）是成功的最显著预测因素。中位手术时间为72分钟。两只犬在激光碎石术后发生尿路梗阻。分别在第0天、第1天、第3天和第11天，53%、84%、13%和3%的犬检测到血尿。分别在第0天、第1天、第3天和第11天，13%、47%、0%和3%的犬检测到白细胞尿。