Grant David C, Harper Tisha A M, Werre Stephen R
Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA.
J Am Vet Med Assoc. 2010 Apr 1;236(7):763-6. doi: 10.2460/javma.236.7.763.
To determine the effectiveness of cystotomy for complete removal of urocystoliths and urethroliths in dogs, the types and frequency of diagnostic imaging performed to verify complete urolith removal, the complications that develop as a result of cystotomy, and predictors of each of these variables.
Retrospective case series.
128 dogs that underwent a cystotomy for removal of urocystoliths, urethroliths, or both from 1994 through 2006.
The following data were obtained from medical records: sex, body weight, number and locations of lower urinary tract uroliths identified in preoperative and postoperative imaging reports, types of imaging used for urolith detection, number of uroliths recovered during cystotomy, quantitative urolith composition, and major complications attributable to cystotomy. Objective criteria were applied to determine whether a cystotomy failed or succeeded and whether appropriate imaging was performed. Associations between potential prognostic factors and outcomes were statistically assessed.
Effectiveness of cystotomy could be determined in 44 (34%) dogs, of which 9 (20%) had incomplete removal of uroliths. Appropriate postoperative imaging was performed for only 19 (15%) dogs, of which 8 had incomplete removal. Dogs with both urethroliths and urocystoliths were more likely to have a failed cystotomy than dogs with only urethroliths or urocystoliths. Complications developed in 5 (4%) dogs.
Cystotomy was a safe and effective surgical procedure for removal of lower urinary tract uroliths in most dogs. Failure to remove all uroliths occurred in a substantial percentage of patients.
确定膀胱切开术在犬完全清除膀胱结石和尿道结石方面的有效性、用于验证尿道结石完全清除的诊断成像类型及频率、膀胱切开术导致的并发症以及这些变量各自的预测因素。
回顾性病例系列研究。
1994年至2006年期间接受膀胱切开术以清除膀胱结石、尿道结石或两者皆有的128只犬。
从病历中获取以下数据:性别、体重、术前和术后成像报告中确定的下尿路结石数量和位置、用于结石检测的成像类型、膀胱切开术中回收的结石数量、结石定量成分以及膀胱切开术导致的主要并发症。应用客观标准来确定膀胱切开术是否失败或成功以及是否进行了适当的成像检查。对潜在预后因素与结果之间的关联进行统计学评估。
在44只(34%)犬中可确定膀胱切开术的有效性,其中9只(20%)结石清除不完全。仅19只(15%)犬进行了适当的术后成像检查,其中8只结石清除不完全。同时患有尿道结石和膀胱结石的犬比仅患有尿道结石或膀胱结石的犬更有可能膀胱切开术失败。5只(4%)犬出现了并发症。
在大多数犬中,膀胱切开术是一种安全有效的用于清除下尿路结石的外科手术。相当比例的患者未能清除所有结石。