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25只雌性犬通过开放手术或膀胱镜引导激光消融治疗异位输尿管的结果。

Outcomes of 25 female dogs treated for ectopic ureters by open surgery or cystoscopic-guided laser ablation.

作者信息

Dekerle Bastien, Maurice Emeline, Decambron Adeline, Viateau Véronique, Maurey Christelle, Manassero Mathieu

机构信息

Department of Surgery, ChuvA, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.

Department of Internal Medicine, ChuvA, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.

出版信息

Vet Surg. 2022 May;51(4):568-575. doi: 10.1111/vsu.13807. Epub 2022 Mar 29.

Abstract

OBJECTIVE

To report outcomes after the correction of ectopic ureter (EU) by open surgery or cystoscopic-guided laser ablation (CLA) in female dogs.

STUDY DESIGN

Retrospective study from 2011 to 2018.

ANIMALS

Twenty-five female dogs.

METHODS

Data collected included signalment, clinicopathologic data, procedural data, complications, and short-term and long-term outcomes. Complications were graded as minor or major if a surgical revision was required. Continence status was scored subjectively (1 = completely incontinent to 10 = fully continent).

RESULTS

Fifteen dogs had bilateral EU and 24 had intramural EU (iEU). Open surgical correction included 13 neoureterostomies, 2 neocystoureterostomies, and a combination of these in 2 dogs. Eight dogs underwent CLA. Eighteen dogs experienced minor complications (72%), and 2 experienced major complications (8%). One-month postoperative continence was achieved in 20/25 (80%) dogs (median score of 10). Incontinence recurred at a median time of 24.9 months in 5 dogs but responded to medical treatment. Overall, dogs remained continent for 66 months (median) and 22/25 (88%) dogs achieved continence with adjunction of medical/surgical treatment in incontinent ones. Fewer minor complications and postoperative recurrences of incontinence were documented after CLA than neoureterostomy (P < .01 and P < .05).

CONCLUSION

Ectopic ureter correction by open surgery or CLA resulted in a subjectively good prognosis, most dogs reaching continence within a month of surgery, although incontinence occasionally recurred in the long term. CLA was associated with fewer complications and incontinence recurrences than neoureterostomy.

CLINICAL SIGNIFICANCE

Cystoscopic-guided laser ablation should be preferred to correct iEU to prevent short-term complications and the recurrence of incontinence. Further studies should investigate the cause of postoperative recurrence of urinary incontinence.

摘要

目的

报告雌性犬开放性手术或膀胱镜引导下激光消融术(CLA)矫正异位输尿管(EU)后的结果。

研究设计

2011年至2018年的回顾性研究。

动物

25只雌性犬。

方法

收集的数据包括特征、临床病理数据、手术数据、并发症以及短期和长期结果。如果需要手术修正,则将并发症分为轻度或重度。自主排尿状态采用主观评分(1 = 完全失禁至10 = 完全自主排尿)。

结果

15只犬为双侧EU,24只为壁内EU(iEU)。开放性手术矫正包括13例新输尿管造口术、2例新膀胱输尿管造口术以及2只犬采用了这两种手术的联合。8只犬接受了CLA。18只犬出现轻度并发症(72%),2只出现重度并发症(8%)。20/25(80%)只犬术后1个月实现自主排尿(中位评分为10分)。5只犬在中位时间24.9个月时尿失禁复发,但对药物治疗有反应。总体而言,犬保持自主排尿状态的时间为66个月(中位时间),22/25(88%)只犬在失禁时通过药物/手术治疗辅助实现了自主排尿。与新输尿管造口术相比,CLA术后记录到的轻度并发症和尿失禁复发较少(P < 0.01和P < 0.05)。

结论

开放性手术或CLA矫正异位输尿管导致主观预后良好,大多数犬在手术后1个月内达到自主排尿,尽管尿失禁偶尔会在长期复发。与新输尿管造口术相比,CLA相关的并发症和尿失禁复发较少。

临床意义

膀胱镜引导下激光消融术应优先用于矫正iEU,以预防短期并发症和尿失禁复发。进一步的研究应调查术后尿失禁复发的原因。

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