Buote Nicole J, Hayes Galina, Bisignano Joseph, Rosselli Desiree
VCA West Los Angeles, Los Angeles, CA, USA.
Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
J Feline Med Surg. 2022 Oct;24(10):1032-1038. doi: 10.1177/1098612X211066477. Epub 2021 Dec 14.
The aim of this study was to compare the outcomes of cats undergoing open cystotomy with those undergoing minimally invasive surgery (MIS) for removal of cystic calculi by use of a composite outcome score.
Twenty-eight cats were retrospectively enrolled and divided into two groups: open cystotomy (n = 14) and MIS (n = 14). The primary outcome measure was a composite outcome score, including three variables: pain scores ⩾2 at either 6 or 12 h postoperatively; failure to remove all stones as determined by postoperative radiographs; and postoperative complications requiring a visit to the hospital separate from the planned suture removal appointment. Other data collected included signalment, history, other procedures performed during anesthesia, willingness to eat the day after surgery and the financial cost of the procedures.
There was no significant difference in age, weight, sex or breed between the two groups. The risk of experiencing the composite outcome was 3/14 (21.4%) in the MIS group and 10/14 (71%) in the open procedure group ( = 0.02). The cats in the open surgery group had 8.3 times greater odds of developing the composite outcome than cats in the MIS group (odds ratio 8.3, 95% confidence interval 1.3-74.4; = 0.02). In the MIS group, 10/14 cats were eating the day after surgery vs 3/14 in the open procedure group ( = 0.02). The procedural cost was higher in the MIS group, with a median cost of US$945 (interquartile range [IQR] US$872-1021) vs US$623 (IQR US$595-679) in the open group ( <0.01).
In this study the composite outcome score provided evidence to support the use of MIS techniques in cats with cystic calculi. The composite outcome score should be considered in future veterinary studies as a promising method of assessing clinically relevant outcomes.
本研究旨在通过使用综合结局评分，比较接受开放性膀胱切开术的猫与接受微创手术（MIS）摘除膀胱结石的猫的结局。
回顾性纳入28只猫，分为两组：开放性膀胱切开术组（n = 14）和MIS组（n = 14）。主要结局指标是综合结局评分，包括三个变量：术后6小时或12小时疼痛评分≥2；术后X光片显示结石未全部清除；术后并发症需要在计划的拆线预约之外单独就诊。收集的其他数据包括特征、病史、麻醉期间进行的其他手术、术后第一天的进食意愿以及手术费用。
两组在年龄、体重、性别或品种方面无显著差异。MIS组出现综合结局的风险为3/14（21.4%），开放性手术组为10/14（71%）（P = 0.02）。开放性手术组的猫出现综合结局的几率比MIS组的猫高8.3倍（优势比8.3，95%置信区间1.3 - 74.4；P = 0.02）。在MIS组，10/14的猫术后第一天进食，而开放性手术组为3/14（P = 0.02）。MIS组的手术费用更高，中位数为945美元（四分位间距[IQR]为872 - 1021美元），而开放性手术组为623美元（IQR为595 - 679美元）（P < 0.01）。
在本研究中，综合结局评分提供了证据支持在患有膀胱结石的猫中使用MIS技术。在未来的兽医研究中，综合结局评分应被视为评估临床相关结局的一种有前景的方法。
