RESUMO
Ureteral ectopia is rare and requires surgical treatment after a thorough diagnostic workup. Open surgical techniques for repositioning ectopic ureters have been known for many years and are well described in the literature. However, to the best of our knowledge, no laparoscopic method of correcting this pathology has been described, which, in our opinion, would benefit the animal in terms of the healing process and overall clinical outcomes. This study aimed to evaluate the possibility of laparoscopic treatment of ureteral ectopia, which causes urinary incontinence in dogs. All of the operated ten dogs presented in this study were client-owned females with symptoms of urinary incontinence due to a unilateral intramural ectopic ureter. A three-trocar laparoscopic technique was used to perform the ureteroneocystostomy of the ectopic ureter. In this article, clinicopathological data, imaging features, procedural findings, complications, and short- and long-term outcomes are presented. The procedure was feasible in all cases. No major postoperative complications were observed. Among the minor complications, slight hematuria was observed in three dogs, which resolved spontaneously. In the period of at least one year after surgery, no negative impact of the procedure was observed. Seven of the ten operated dogs regained urinary continence. The remaining three dogs required additional surgery (urethral bulking) because of a lack of improvement after adjuvant pharmacological treatment. Overall, good-to-excellent long-term outcomes can be achieved; however, dogs that remain incontinent after laparoscopic ureteroneocystostomy may require additional treatment.
Assuntos
Coristoma , Doenças do Cão , Laparoscopia , Ureter , Doenças Ureterais , Obstrução Ureteral , Incontinência Urinária , Cães , Feminino , Humanos , Animais , Ureter/cirurgia , Ureter/patologia , Projetos Piloto , Doenças Ureterais/diagnóstico , Doenças Ureterais/cirurgia , Doenças Ureterais/veterinária , Doenças do Cão/patologia , Estudos Retrospectivos , Incontinência Urinária/etiologia , Incontinência Urinária/cirurgia , Incontinência Urinária/veterinária , Laparoscopia/efeitos adversos , Obstrução Ureteral/complicações , Coristoma/patologiaRESUMO
All the surgical approaches described to date for the removal of distal urethral tumors have some technical difficulties that make these tumors difficult to treat. The article presents for the first time the treatment results of three female dogs, diagnosed with transitional cell carcinomas of the distal urethra, operated with a newly developed hybrid surgical method-a combination of laparoscopy and open surgery. This technique uses vulvovaginectomy, combined with resection of the distal urethra and prepubic urethrostomy. All of the procedures were possible to perform, without the need to carry out a laparotomy conversion. Histopathology revealed transitional cell carcinoma in all cases, with a margin of healthy tissues maintained in two out of three cases, which meant reoperation of the urethrostomy site in the remaining one case. The mean survival time was nine months. Among minor complications, recurrent cystitis was found. After the first surgery, all dogs retained full control over urination immediately after recovery from anesthesia. In one case that required reoperation, complete urinary incontinence occurred after the second procedure. The present findings suggest that hybrid surgery can be used to treat distal urethral tumors. Qualification for surgery must be limited to bitches with tumors of the distal urethra and without metastases, without the possibility of using other surgical methods, and with the owner's full acceptance of the risk of complications.
RESUMO
Tumours of the distal urethra in female dogs are often difficult to treat, and the surgical methods described thus far have technical limitations. This study aimed to present a novel approach to the surgical treatment of distal urethral tumours. This study used dog cadavers to evaluate the technical feasibility of surgically removing neoplastic lesions in the distal urethra and compared surgical outcomes of open surgery with those of hybrid surgery (combination of laparoscopy and open surgery). Open intact, open spayed, hybrid intact, and hybrid spayed dog cadaver groups underwent surgery (n = 6 per group). The novel surgical method was based on vulvovaginectomy (ovariohysterectomy in intact dogs), resection of the distal part of the urethra, and pre-pubic urethrostomy. Outcomes of interest included technical feasibility of each procedure, using both surgical techniques, wound length, time required to complete the procedure, and the incidence of intraoperative ureter and rectum injuries. Surgical technique and reproductive status affected operating time. Technique choice affected wound length; the surgical wound was longer in the open group than in the hybrid group. Macroscopic evaluation of the rectum did not reveal any damage to the wall. There was no evidence of ureter leakage or obstruction in any case. The present findings suggest that both open and hybrid surgery can be used to treat distal urethral tumours.
Assuntos
Doenças do Cão , Neoplasias Uretrais , Animais , Cadáver , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Cães , Feminino , Masculino , Uretra/patologia , Uretra/cirurgia , Neoplasias Uretrais/cirurgia , Neoplasias Uretrais/veterináriaRESUMO
Regenerative medicine is a dynamically developing field of human and veterinary medicine. The animal model was most commonly used for mesenchymal stem cells (MSCs) treatment in experimental and preclinical studies with a satisfactory therapeutic effect. Year by year, the need for alternative treatments in veterinary medicine is increasing, and other applications for promising MSCs and their biological derivatives are constantly being sought. There is also an increase in demand for other methods of treating disease states, of which the classical treatment methods did not bring the desired results. Cell therapy can be a realistic option for treating human and animal diseases in the near future and therefore additional research is needed to optimize cell origins, numbers, or application methods in order to standardize the treatment process and assess its effects. The aim of the following work was to summarize available knowledge about stem cells in veterinary medicine and their possible application in the treatment of chosen musculoskeletal disorders in dogs and horses.