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经膀胱经皮膀胱结石切除术用于犬猫膀胱及尿道结石取出:27例(2006 - 2008年)

Transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi in dogs and cats: 27 cases (2006-2008).

作者信息

Runge Jeffrey J, Berent Allyson C, Mayhew Philipp D, Weisse Chick

机构信息

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

J Am Vet Med Assoc. 2011 Aug 1;239(3):344-9. doi: 10.2460/javma.239.3.344.

Abstract

OBJECTIVE

To describe the use of transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi and to report the outcome in dogs and cats.

DESIGN

Retrospective case series.

ANIMALS

23 dogs and 4 cats.

PROCEDURES

Medical records were reviewed for signalment, procedure time, stone number, stone location, pre- and postoperative radiographs, procedure-associated complications, and short-term outcome. A ventral midline approach was made into the abdomen over the urinary bladder apex. A screw cannula was inserted at the bladder apex for normograde rigid and flexible cystourethroscopy. All uroliths were removed via a stone basket device and retrograde flushing and suction. Long-term follow-up (1 year after surgery) information was obtained by telephone or e-mail contact with owners.

RESULTS

27 animals with cystic and urethral calculi were included. Median patient weight was 8.3 kg (18.3 lb; range, 1.8 to 42.6 kg [4.0 to 93.7 lb]). Urolith number ranged from 1 to > 35 (median, 7). Urolith size ranged from < 1 to 30 mm (median, 4.5 mm). Fifteen of the 27 animals had a previous cystotomy (range, 1 to 5 procedures). Median procedure time was 66 minutes (range, 50 to 80 minutes). All patients were discharged within 24 hours. No postoperative complications were reported at the time of suture removal. At the time of long-term follow-up, the 22 clients that could be contacted were satisfied with the procedure.

CONCLUSIONS AND CLINICAL RELEVANCE

Transvesicular percutaneous cystolithotomy may decrease the need for urethrotomy, serial transurethral endoscopic procedures, and abdominal insufflation associated with other minimally invasive interventions currently available. This procedure also provided excellent visualization for bladder and urethral luminal inspection.

摘要

目的

描述经膀胱经皮膀胱结石切除术用于取出膀胱和尿道结石的方法,并报告犬猫的手术结果。

设计

回顾性病例系列研究。

动物

23只犬和4只猫。

方法

查阅病历,记录动物特征、手术时间、结石数量、结石位置、术前和术后X线片、手术相关并发症及短期结果。经腹中线在膀胱顶部做切口。在膀胱顶部插入螺旋套管用于顺行性硬性和软性膀胱尿道镜检查。所有尿路结石均通过结石篮装置及逆行冲洗和抽吸取出。通过电话或电子邮件与主人联系获取长期随访(术后1年)信息。

结果

纳入27只患有膀胱和尿道结石的动物。动物中位体重为8.3 kg(18.3磅;范围为1.8至42.6 kg [4.0至93.7磅])。尿路结石数量为1至>35个(中位值为7个)。尿路结石大小为<1至30 mm(中位值为4.5 mm)。27只动物中有15只曾接受过膀胱切开术(范围为1至5次手术)。中位手术时间为66分钟(范围为50至80分钟)。所有患者均在24小时内出院。拆线时未报告术后并发症。在长期随访时,与22位可联系到的主人沟通得知他们对手术满意。

结论及临床意义

经膀胱经皮膀胱结石切除术可能减少尿道切开术、系列经尿道内镜手术以及与目前其他可用的微创干预相关的腹部充气的需求。该手术还为膀胱和尿道腔检查提供了极佳的视野。

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