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猫输尿管手术和输尿管支架置入的结果:117例(2006 - 2014年)

Outcomes of ureteral surgery and ureteral stenting in cats: 117 cases (2006-2014).

作者信息

Wormser Chloe, Clarke Dana L, Aronson Lillian R

出版信息

J Am Vet Med Assoc. 2016 Mar 1;248(5):518-25. doi: 10.2460/javma.248.5.518.

Abstract

OBJECTIVE

To evaluate and compare outcomes in cats following ureteral surgery or ureteral stent placement.

DESIGN

Retrospective case series.

ANIMALS

117 cats.

PROCEDURES

Data regarding signalment, history, concurrent disease, clinical signs, clinicopathologic tests, surgical procedures, and perioperative complications (including death) were recorded. Follow-up data, including presence of signs of chronic lower urinary tract disease, chronic urinary tract infection, reobstruction, and death, if applicable, were obtained by records review or telephone contact with owners. Variables of interest were compared statistically between cats treated with and without stent placement. Kaplan-Meier analysis and Cox regression were performed to assess differences in survival time between cats with and without ureteral stents.

RESULTS

Perioperative complications referable to the urinary tract were identified in 6 of 43 (14%) cats that had ≥ 1 ureteral stent placed and 2 of 74 (3%) cats that underwent ureteral surgery without stenting. Perioperative mortality rates were similar between cats with (4/43 [9%]) and without (6/74 [8%]) stents. After surgery, signs of chronic lower urinary tract disease and chronic urinary tract infection were significantly more common among cats with than cats without stents. Nineteen of 87 (22%) cats with follow-up information available had recurrent obstruction; incidence of reobstruction did not differ between cats with and without stents. Median survival time did not differ between the 2 groups.

CONCLUSIONS AND CLINICAL RELEVANCE

The potential for signs of chronic lower urinary tract disease and chronic infection, particularly among cats that receive ureteral stents, warrants appropriate client counseling. Judicious long-term follow-up for detection of reobstruction is recommended.

摘要

目的

评估并比较猫输尿管手术后或输尿管支架置入后的结果。

设计

回顾性病例系列研究。

动物

117只猫。

方法

记录有关动物特征、病史、并发疾病、临床症状、临床病理检查、手术过程及围手术期并发症(包括死亡)的数据。通过查阅记录或与猫主人电话联系获取随访数据,包括慢性下泌尿道疾病体征、慢性尿路感染、再次梗阻及死亡情况(如适用)。对置入支架和未置入支架的猫的相关变量进行统计学比较。采用Kaplan-Meier分析和Cox回归评估有输尿管支架和无输尿管支架的猫在生存时间上的差异。

结果

在43只至少置入1个输尿管支架的猫中,有6只(14%)出现与泌尿道相关的围手术期并发症;在74只接受输尿管手术但未置入支架的猫中,有2只(3%)出现此类并发症。置入支架的猫(4/43 [9%])和未置入支架的猫(6/74 [8%])围手术期死亡率相似。术后,慢性下泌尿道疾病体征和慢性尿路感染在置入支架的猫中比未置入支架的猫更常见。在87只可获得随访信息的猫中,有19只(22%)出现复发性梗阻;置入支架和未置入支架的猫再次梗阻发生率无差异。两组的中位生存时间无差异。

结论及临床意义

慢性下泌尿道疾病体征和慢性感染的可能性,尤其是在接受输尿管支架置入的猫中,需要对客户进行适当的咨询。建议进行明智的长期随访以检测再次梗阻情况。

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