Initial leak pressures of four anastomosis techniques in cooled cadaveric canine jejunum.

OBJECTIVE: To compare the effectiveness of four different intestinal anastomosis techniques at preventing leakage after enterectomy. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Grossly normal jejunal segments (N = 70) from three fresh canine cadavers. METHODS: Eight-centimeter cooled canine cadaveric jejunal segments were randomly assigned to a control group (six segments) and four treatment groups (16 segments each [two segments/anastomotic construct]): (1) handsewn anastomosis (HSA), (2) barbed suture anastomosis (B-HSA), (3) stapled functional end-to-end anastomosis (SFEEA), and (4) stapled functional end-to-end anastomosis with an oversew (SFEEA-O). Control segments and anastomotic constructs were infused intraluminally to the point of leakage. Initial leak pressures were recorded and compared. RESULTS: Initial leak pressures (median + range) for jejunal control segments, HSA, B-HSA, SFEEA, and SFEEA-O were 331.88 mmHg (range, 315.34-346.64), 35.17 (20.29-56.24), 24.99 (6.08-38.64), 28.77 (18.80-85.09), and 35.92 (12.05-80.71), respectively. No difference was detected between leak pressures of anastomosed segments (P = .35), all of which were more variable and lower than those of intact segments. CONCLUSION: No difference in initial leak pressures was detected between the four anastomosis techniques tested in cooled canine cadaveric jejunum. CLINICAL SIGNIFICANCE: All four anastomosis techniques evaluated in this study may be suitable in dogs.

Outcome of laparoscopic adrenalectomy for resection of unilateral noninvasive adrenocortical tumors in 11 cats.

OBJECTIVE: To describe the technique and outcomes of laparoscopic adrenalectomy (LA) in cats with adrenocortical neoplasia. STUDY DESIGN: Retrospective case series. ANIMALS: Eleven client-owned cats with unilateral adrenal tumors. METHODS: Medical records of cats that underwent LA for unilateral functional adrenal tumors at 3 veterinary teaching hospitals were reviewed. Data collected included signalment, clinical signs, physical examination findings, diagnostic imaging results, preoperative laboratory tests, laparoscopic port placement and techniques, duration of anesthesia and surgery, complications, concomitant procedures, need for conversion to an open celiotomy, histopathological diagnosis, and postoperative survival. RESULTS: Eleven cats were included, 5 with right-sided and 6 with left-sided tumors. Tumors were aldosterone-secreting (n = 8), progesterone-secreting (n = 2), or testosterone-secreting (n = 1). Adrenalectomy was successfully performed in all 11 cats although 4 cases required conversion to an open celiotomy, due to poor visualization (n = 2), close adherence of the tumor to the caudal vena cava (n = 1), and inability to maintain adequate pneumoperitoneum (n = 1). Ten of the 11 cats were discharged from the hospital, with a median survival time of 803 days (range 467-1123 days). One cat died from severe pancreatitis and cardiogenic pulmonary edema. CONCLUSION: Adrenalectomy can be performed in cats via laparoscopy but is technically challenging, and associated with a relatively high conversion rate (36%).

Perioperative Complications and Outcome of Laparoscopic Cholecystectomy in 20 Dogs.

OBJECTIVE: To report the complications and outcome of dogs undergoing laparoscopic cholecystectomy for uncomplicated gall bladder disease. STUDY DESIGN: Multi-institutional case series. ANIMALS: Client-owned dogs (n=20). METHODS: Medical records of dogs that underwent laparoscopic cholecystectomy were reviewed and signalment, history, clinical and ultrasound examination findings, surgical variables, and complications were collated. Laparoscopic cholecystectomy was performed using a multiport approach. Data were compared between dogs with successful laparoscopic cholecystectomy and dogs requiring conversion to open cholecystectomy. RESULTS: Six dogs (30%) required conversion from laparoscopic to open cholecystectomy due to inability to ligate the cystic duct (3), evidence of gall bladder rupture (1), leakage from the cystic duct during dissection (1), and cardiac arrest (1). Cystic duct dissection was performed in 19 dogs using an articulating dissector (10), right angle forceps (7), and unrecorded (2). The cystic duct was ligated in 15 dogs using surgical clips (5), suture (6), or a combination (4). All dogs were discharged from the hospital and had resolution of clinical signs, although 1 dog developed pancreatitis and 1 dog required revision surgery for bile peritonitis. There was no significant difference in preoperative blood analysis results, surgical technique, or duration of hospitalization between dogs undergoing laparoscopic cholecystectomy and cases converted to open cholecystectomy. CONCLUSION: Laparoscopic cholecystectomy can be performed successfully for uncomplicated gall bladder disease in dogs after careful case selection. The surgeon considering laparoscopic cholecystectomy should be familiar with a variety of methods for cystic duct dissection and ligation to avoid difficulties during the procedure.