Ricardo Huppes Rafael, Crivellenti Leandro Z, Barboza De Nardi Andrigo, Roque Lima Bruno, Alves Cintra Cristiane, Luiz Costa Castro Jorge, Adin Christopher A
Department of Veterinary Clinic and Surgery, Faculdade Uningá, Maringá, Brazil.
Department of Veterinary Clinic and Surgery, Franca University (UNIFRAN), Franca, Brazil.
Vet Surg. 2017 Jan;46(1):111-119. doi: 10.1111/vsu.12583. Epub 2016 Dec 1.
To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs.
Retrospective study.
Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4).
Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed. Both ureters were transected and anastomosed to the ventral abdominal skin. Polyvinyl chloride catheters were placed in the ureteral stomas and maintained for 5 days. After catheter removal, dogs were managed with an absorbent diaper over the stomas. Long-term outcome and survival were documented by follow-up visits or phone contact.
Median age at the time of surgery was 10.3 years (range, 8-12). Average procedural time was ∼4.7 hours (range, 3.8-6.1). Minor complications occurred in all dogs, including bleeding and edema of the ureterostomy site during the first 2-3 days after surgery. One dog developed urine scald that resolved with improved stoma care and hygiene. Median survival time after surgery was 278.6 days (range, 47-498). Distant metastases were documented in 2 dogs at 47 days (bone) and 369 days (lung) after surgery.
Radical cystectomy with cutaneous ureterostomy is a viable salvage procedure for urinary diversion after cystectomy in dogs with invasive bladder neoplasia. Postoperative management and quality of life were considered acceptable by most owners. Future studies are warranted to evaluate survival time in a larger number of animals.
描述根治性膀胱切除术联合皮肤输尿管造口术治疗犬浸润性膀胱肿瘤。
回顾性研究。
患有膀胱三角区移行细胞癌的客户自养犬（n = 4）。
回顾性分析因膀胱三角区移行细胞癌接受根治性膀胱切除术和淋巴结清扫术后行皮肤输尿管造口术的犬的围手术期并发症和长期预后。双侧输尿管切断并与腹侧腹壁皮肤吻合。将聚氯乙烯导管置于输尿管造口处并保留5天。拔除导管后，用吸水尿布覆盖造口处对犬进行护理。通过随访或电话联系记录长期预后和生存情况。
手术时的中位年龄为10.3岁（范围8 - 12岁）。平均手术时间约为4.7小时（范围3.8 - 6.1小时）。所有犬均出现轻微并发症，包括术后头2 - 3天输尿管造口部位出血和水肿。1只犬出现尿灼伤，通过改善造口护理和卫生状况得以缓解。术后中位生存时间为278.6天（范围47 - 498天）。2只犬分别在术后47天（骨）和369天（肺）出现远处转移。
根治性膀胱切除术联合皮肤输尿管造口术是患有浸润性膀胱肿瘤的犬膀胱切除术后可行的挽救性尿路改道手术。大多数犬主认为术后管理和生活质量可以接受。有必要开展进一步研究以评估更多动物的生存时间。
