Milovancev Milan, Scharf Valery F, Townsend Katy L, Singh Ameet, Tremolada Giovanni, Worley Deanna, Schmiedt Chad W
Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
Vet Surg. 2020 May;49(4):794-799. doi: 10.1111/vsu.13395. Epub 2020 Feb 10.
To describe the use of a bipolar sealing device (BSD) for partial cystectomy in dogs undergoing excision of bladder tumors.
Multicenter, prospective, clinical pilot study.
Seven client-owned dogs with nontrigonal urinary bladder lesions.
Dogs underwent a sealed partial cystectomy with a BSD, with or without cystoscopic guidance of the resection. The sealed cystectomy site was oversewn with a single-layer simple continuous pattern with monofilament absorbable suture.
Sealed partial cystectomy was successfully performed in all dogs, with a median surgical duration of 69 minutes (range, 50-120). Lesions were located at the apex in six dogs and on the ventral midbody of the bladder in one dog. No urine leakage from the BSD luminal seal was visible prior to suture closure in three dogs, while varying amounts of urine leaked from the sealed site in four dogs. Suture was placed over the seal in grossly normal bladder tissue in six dogs and in the BSD peripheral thermal effect zone in one dog; in this latter dog, revision cystorrhaphy was required 3 days later because of uroabdomen. The other six dogs had no clinical evidence of urinary bladder healing complications.
The integrity of the seal generated by the BSD tested here on partial cystectomies varied between dogs and was unpredictable.
Sealed partial cystectomy with a BSD may reduce exposure of urinary bladder luminal contents to the surgical site. However, the placement of sutures over the seal and through grossly normal bladder tissue is recommended to prevent postoperative uroabdomen.
描述在接受膀胱肿瘤切除的犬中使用双极密封装置（BSD）进行部分膀胱切除术的情况。
多中心、前瞻性临床试点研究。
7只客户拥有的患有非三角区膀胱病变的犬。
犬接受使用BSD的密封部分膀胱切除术，切除过程有或没有膀胱镜引导。密封的膀胱切除部位用单丝可吸收缝线以单层简单连续缝合法进行缝合。
所有犬均成功进行了密封部分膀胱切除术，手术中位持续时间为69分钟（范围50 - 120分钟）。6只犬的病变位于膀胱尖部，1只犬的病变位于膀胱腹侧中部。3只犬在缝合关闭前未见BSD腔内密封处有尿液渗漏，4只犬的密封部位有不同程度的尿液渗漏。6只犬在大体正常的膀胱组织上缝合覆盖密封处，1只犬在BSD周边热效应区缝合；在这只犬中，3天后因尿腹症需要进行膀胱修补术。其他6只犬没有膀胱愈合并发症的临床证据。
在此对部分膀胱切除术测试的BSD产生的密封完整性在犬之间存在差异且不可预测。
使用BSD进行密封部分膀胱切除术可能会减少膀胱腔内内容物暴露于手术部位。然而，建议在密封处及通过大体正常的膀胱组织放置缝线以预防术后尿腹症。
