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犬猫输尿管梗阻:传统及新型介入诊断与治疗方法综述

Ureteral obstructions in dogs and cats: a review of traditional and new interventional diagnostic and therapeutic options.

作者信息

Berent Allyson C

机构信息

Animal Medical Center, 510 E. 62nd St, New York, NY 10065, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2011 Apr;21(2):86-103. doi: 10.1111/j.1476-4431.2011.00628.x.

Abstract

OBJECTIVE

To describe and review both traditional and newer diagnostic and therapeutic options for canine and feline ureteral obstructions currently being performed clinically in veterinary medicine.

DATA SOURCES

A Medline search with no date restrictions was used for this review.

HUMAN DATA SYNTHESIS

The human literature would support the use of minimally invasive endourological techniques for the treatment of nearly all causes of ureteral obstructions, whenever possible. This typically includes extracorporeal shockwave lithotripsy, intracorporeal lithotripsy via retrograde ureteroscopy or antegrade percutaneous nephroureterolithotomy, ureteral stenting, percutaneous nephrostomy tube placement, and laparoscopic endopyelotomy. Typically open surgery is only suggested in cases of ureteral or gynecological malignancy when en bloc resection is considered a good option, or when various methods of endourological techniques have failed.

VETERINARY DATA SYNTHESIS

The veterinary literature is scarce on the use of interventional endourological techniques for the treatment of ureteral obstructions and has been growing over the last 5 years. The current literature reports the use of extracorporeal shockwave lithotripsy for ureteral stones, as well as the use of ureteral stents for the treatment of trigonal obstructive transitional cell carcinoma, ureterolithiasis, and ureteral strictures. Traditional surgical interventions, like ureterotomy, ureteronephrectomy, and ureteral reimplantation is more vastly reported and accepted. This review will focus on new clinical data using interventional endourological techniques for ureteral obstructions.

CONCLUSIONS

Various treatment options for ureteral obstructions are now available for veterinary patients, and the trend away from traditional surgical techniques will hopefully be followed now that they are technically and clinically available for dogs and cats.

摘要

目的

描述并综述目前兽医学临床中用于犬猫输尿管梗阻的传统及更新的诊断和治疗选择。

数据来源

本综述使用了无日期限制的Medline检索。

人类数据综合

人类文献支持尽可能使用微创腔内泌尿外科技术治疗几乎所有输尿管梗阻病因。这通常包括体外冲击波碎石术、经逆行输尿管镜或顺行经皮肾输尿管切开取石术的体内碎石术、输尿管支架置入术、经皮肾造瘘管置入术以及腹腔镜肾盂内切开术。通常仅在考虑整块切除是较好选择的输尿管或妇科恶性肿瘤病例,或各种腔内泌尿外科技术方法均失败时才建议进行开放手术。

兽医数据综合

关于介入性腔内泌尿外科技术治疗输尿管梗阻的兽医文献较少,且在过去5年中不断增加。当前文献报道了体外冲击波碎石术用于治疗输尿管结石,以及输尿管支架用于治疗膀胱三角区梗阻性移行细胞癌、输尿管结石病和输尿管狭窄。传统外科手术干预,如输尿管切开术、输尿管肾切除术和输尿管再植术的报道和接受程度更高。本综述将聚焦于使用介入性腔内泌尿外科技术治疗输尿管梗阻的新临床数据。

结论

现在有多种治疗输尿管梗阻的选择可供兽医患者使用,鉴于这些技术在犬猫身上在技术和临床上均可行,有望出现摒弃传统外科技术的趋势。

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