RESUMO
OBJECTIVE: To report outcomes of thoracoscopic (TL) and thoracoscopic-assisted lung lobectomy (TAL) for treatment of non-neoplastic pulmonary consolidation (PC) in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Twelve client-owned dogs. METHODS: The medical records of 12 dogs that underwent TL or TAL for PC at 3 veterinary institutions between 2011 and 2020 were reviewed. Signalment, history, physical examination, diagnostics, days in hospital, anesthetic and procedure times, intraoperative/postoperative complications, conversion rates, duration of indwelling thoracic drain, and long-term outcomes were recorded. RESULTS: Nine patients underwent a TL approach and 3 underwent TAL. In those that underwent TL, conversion to an intercostal thoracotomy was performed in 4 out of 9 dogs. Conversion was performed due to adhesions (n = 3) or poor visualization (1). Histopathologic examination was consistent with pneumonia due to an infectious process (n = 10), bronchioalveolar malformation with abnormal cilia (1), and left-sided cardiac insufficiency vs. pulmonary alveolar proteinosis (1). The mean duration of hospital stay was 4 days (range, 1-6 days). Complications occurred postoperatively in 7 dogs and included self-limiting hemorrhage (n = 3), self-resolving pneumothorax (2), incisional dehiscence (1), and severe dyspnea in a brachycephalic breed leading to euthanasia (1). For the 11 dogs that survived the perioperative period, there was no evidence of recurrence with a median follow up of 24 months (range, 5-120 months). CONCLUSION: Thoracoscopic (TL) and thoracoscopic-assisted lung lobectomy (TAL) is a reasonable surgical approach in select dogs with PC. CLINICIAL RELEVANCE: Conversion rates were higher than those historically reported for dogs undergoing thoracoscopic lung lobectomy for primary lung tumors.
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Doenças do Cão , Pneumopatias , Neoplasias Pulmonares , Cães , Animais , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/veterinária , Cirurgia Torácica Vídeoassistida/métodos , Pneumopatias/cirurgia , Pneumopatias/veterinária , Pulmão/cirurgia , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/veterinária , Toracotomia/veterinária , Complicações Intraoperatórias/veterinária , Pneumonectomia/métodos , Pneumonectomia/veterinária , Resultado do Tratamento , Tempo de Internação , Doenças do Cão/cirurgiaRESUMO
OBJECTIVE: To describe complications and outcomes of dogs undergoing thoracoscopic-assisted (TA) lung lobectomy. STUDY DESIGN: Multi-institutional, retrospective study. ANIMALS: Client-owned dogs (n = 30). METHODS: Medical records of dogs that underwent TA lung lobectomy were reviewed. Signalment, bodyweight, clinical signs, imaging findings, surgical variables, complications, and short-term/long-term outcome were assessed. Thoracoscopic-assisted lung lobectomy was performed with a mini-thoracotomy. RESULTS: Twelve intraoperative complications were recorded in 11 dogs, 6 requiring conversion to open thoracotomy. Reasons for conversion were reported in 5/6 dogs and included adhesions (2), difficultly manipulating the lesion through the mini-thoracotomy (2), and acute oxygen desaturation (1). One lung ventilation was successful in 4 of the 7 dogs in which this was attempted. A linear stapling device (DST series Medtronic, Minneapolis, Minnesota) was used for lung lobe ligation in 14 dogs. Twenty-three dogs underwent surgery for a neoplastic lesion, with 19 of these being carcinoma. The median lesion size was 4.3 cm (range 1-10 cm); margins were clean, except in 1 dog. Complications were documented in 8 dogs prior to discharge, 5 of these being classified as mild. Twenty-nine dogs were discharged at a median of 47 h postoperatively (range 24-120 h). Death was reported in 9 dogs, with a median survival time of 168 days (range 70-868 days). CONCLUSION: Thoracoscopic-assisted lung lobectomy was achieved with few major complications in the population reported here. Dogs were able to be discharged from hospital quickly, with most surviving beyond the follow-up period. CLINICAL SIGNIFICANCE: Thoracoscopic-assisted lung lobectomy may be considered to facilitate the excision of larger pulmonary lesions or to treat smaller dogs, in which a thoracoscopic excision may be technically more challenging.
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Doenças do Cão , Neoplasias Pulmonares , Cães , Animais , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/veterinária , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/veterinária , Resultado do Tratamento , Pneumonectomia/efeitos adversos , Pneumonectomia/veterinária , Pneumonectomia/métodos , Pulmão/cirurgia , Toracotomia/veterinária , Doenças do Cão/cirurgiaRESUMO
OBJECTIVE: To compare the immediate and short-term outcomes of thyroarytenoid lateralization (TAL) and cricoarytenoid lateralization (CAL) for the treatment of canine laryngeal paralysis in dogs. STUDY DESIGN: A prospective, clinical trial. ANIMALS: Fourteen client-owned dogs referred to our hospital because of bilateral laryngeal paralysis. METHODS: Dogs with confirmed laryngeal paralysis were randomly assigned to the CAL or TAL group. Video images of the rima glottidis obtained preoperatively, immediately postoperatively (t0), and 15 days postoperatively (t1) were digitized. The rima glottidis area was measured using image-analysis software. An increase in the rima glottidis area was expressed as a percentage of the preoperative area. RESULTS: The rima glottidis area increased by a mean of 152% at t0 and 127% at t1 for the TAL group and 205% at t0 and 199% at t1 for the CAL group compared with preoperative values. The increase in the rima glottidis area differed (P < .05) between the 2 groups at all postoperative time points. A reduction of the area occurred at t1 in both groups. There was no difference between t0 and t1 (P > .05) in the CAL group but there was a large difference (P < .05) in the TAL group. CONCLUSION: Cricoarytenoid lateralization and TAL were both effective for surgical abduction of the arytenoid cartilage. Although a reduction (P < .05) in the rima glottidis area occurred in the TAL group at t1, we observed no associated clinical signs. CLINICAL SIGNIFICANCE: Cricoarytenoid lateralization and TAL result in good short-term outcomes in dogs with laryngeal paralysis.
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Doenças do Cão , Laringe , Paralisia das Pregas Vocais , Animais , Cartilagem Aritenoide/cirurgia , Doenças do Cão/cirurgia , Cães , Glote/cirurgia , Laringe/cirurgia , Estudos Prospectivos , Paralisia das Pregas Vocais/cirurgia , Paralisia das Pregas Vocais/veterináriaRESUMO
OBJECTIVE: To describe the surgical technique and report the outcomes of adrenalectomy and thrombus removal with kidney preservation by renal venotomy in a population of dogs with adrenal tumors and vascular invasion into the renal vein (RV) and caudal vena cava (CVC). STUDY DESIGN: Short case series. ANIMALS: Five client-owned dogs that underwent adrenalectomy. METHODS: Dogs with adrenal tumors and vascular invasion into the RV and CVC were retrospectively enrolled in this multi-institutional study. Renal venotomy was performed at the time of adrenalectomy for tumor thrombus removal. Recorded data included signalment, clinical signs and results of laboratory testing, physical examination findings, diagnostic imaging results, surgical technique, surgical time, surgical complications, and outcome. RESULTS: Tumor thrombus was removed by renal venotomy in five dogs. In one dog with an ectopic adrenal tumor located ventral to the left kidney, the thrombus was occluding 90% of caval flow, and a small caval venotomy was required to remove it. Kidney preservation was achieved in all dogs. No significant intraoperative or postoperative complications occurred, and all dogs were discharged 3 to 4 days postoperatively. Median surgical time was 125 minutes (range, 80-210). At the end of the study, four dogs were alive without signs of recurrence, while one dog died of a suspected pulmonary embolism at 510 days. Median follow-up was 510 days (range, 279-890). CONCLUSION: Renal venotomy is feasible for thrombectomy in dogs with adrenal tumors and RV invasion and allowed for the preservation of the kidney in this case series, thus limiting perioperative morbidity.
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Neoplasias das Glândulas Suprarrenais/veterinária , Doenças do Cão/cirurgia , Veias Renais/cirurgia , Trombectomia/veterinária , Veia Cava Inferior/cirurgia , Adrenalectomia/veterinária , Animais , Cães , Complicações Intraoperatórias/veterinária , Rim/fisiologia , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Trombectomia/métodosRESUMO
OBJECTIVE: To compare complications of dogs treated with mandibular and sublingual sialoadenectomy for sialocele using a lateral (LAT) or ventral paramedian (VPM) approach. STUDY DESIGN: Retrospective multicenter study. ANIMALS: Dogs (140) with mandibular and sublingual sialocele. METHODS: Medical records of dogs that underwent mandibular and sublingual sialoadenectomy through a LAT or VPM approach from 2004 to 2020 were reviewed. Clinical and histopathological findings were analyzed to compare the groups. RESULTS: Seventy dogs were included in each group. The most represented breed was crossbreed (26%), and males (99/140 [71%], intact/neutered) were overrepresented. Dogs in the VPM approach group were more likely to undergo digastricus tunnelization and placement of a drain or a bandage. Dogs in the LAT approach group were heavier and more likely to undergo excision of an inflammatory pseudocapsule. No difference was detected in complication rates between groups (LAT [20%], VPM [31%], P = .116). Recurrences were more likely after LAT approach (5/70 vs 0/70, respectively; P = .029), whereas wound-related complications were more likely after VPM approach (20/70 vs 9/70, respectively; P = .018). Prolonged duration of surgery was associated with an increased risk of recurrence, and none of the other variables affected the complication rate. CONCLUSION: Ventral paramedian approach for mandibular and sublingual sialoadenectomy was associated with a lower risk of recurrence but a higher risk of wound-related complications compared with LAT approach. CLINICAL SIGNIFICANCE: Ventral paramedian approach for mandibular and sublingual sialoadenectomy may be preferred to reduce recurrence in dogs with sialoceles, but wound-related complications are common.
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Cistos/veterinária , Doenças do Cão/cirurgia , Mucocele/veterinária , Complicações Pós-Operatórias/veterinária , Doenças da Glândula Submandibular/veterinária , Animais , Cistos/cirurgia , Cães , Feminino , Masculino , Mucocele/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Doenças da Glândula Submandibular/patologia , Doenças da Glândula Submandibular/cirurgiaRESUMO
OBJECTIVE: To determine the feasibility of laparoscopic liver lobectomy (LLL) in dogs by using canine cadavers and to describe the clinical application in dogs with liver disease. STUDY DESIGN: Ex vivo experiment and descriptive case series. SAMPLE POPULATION: Twelve canine cadavers and six client-owned dogs. METHODS: Cadavers underwent LLL with an endoscopic stapler. The percentage of liver lobe resected was determined by volume. The distance from the staple line to hilus was measured. Medical records of dogs undergoing LLL were reviewed. RESULTS: In cadavers ≤15 kg, left lateral lobectomy completeness was 87.3% (84.6%-96.6%), and remaining median (interquartile range) hilar length was 1 cm (0.25-1.75). Left medial lobectomy completeness was 72.5% (66.7%-80%), and remaining hilar length was 1.6 cm (0.47-1.75). Central division resection completeness was 68.3% (60%-92.9%), and remaining hilar length was 2.7 cm (0.8-5). Laparoscopic liver lobectomy was not feasible for right division lobes and in cadavers >15 kg. Five dogs with peripheral quadrate or left lateral lobe masses underwent stapled, partial laparoscopic lobectomy (30%-90%). One dog underwent stapled, left lateral lobectomy (90%) after open procedure conversion. Histopathological diagnoses included hepatocellular carcinoma (3), nodular hyperplasia (1), biliary cyst adenoma (1), and fibrosis (1). CONCLUSION: Laparoscopic liver lobectomy of the left and central divisions is feasible in cadavers ≤15 kg with an endoscopic stapler. Partial LLL of the left and central divisions is feasible in select dogs with liver disease. CLINICAL SIGNIFICANCE: Laparoscopic liver lobectomy may be a viable alternative to laparotomy in small-to-medium size dogs with peripheral liver masses of the left and central divisions.
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Doenças do Cão , Laparoscopia , Neoplasias Hepáticas , Animais , Doenças do Cão/cirurgia , Cães , Estudos de Viabilidade , Hepatectomia/veterinária , Laparoscopia/veterinária , Fígado/cirurgia , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/veterináriaRESUMO
OBJECTIVE: To describe the surgical technique for nasal planum reconstruction with a lip-to-nose flap after curative intent surgical excision of squamous cell carcinoma (SCC) in cats and to report the surgical outcomes. STUDY DESIGN: Short case series. ANIMALS: Seven cats with SCC of the lateral (n = 6) or dorsal (n = 1) aspect of the nasal planum. METHODS: After tumor excision, a mucocutaneous lip-to-nose flap was harvested from the upper lip and transposed to reconstruct the nasal planum. Variables recorded included surgical time, surgical complications, healing complications, flap success rate, and cosmetic and long-term functional outcomes. RESULTS: Median surgical time was 67.5 minutes (range 49-80), and no intraoperative complications occurred. Postoperatively, six cats developed self-limiting edema of the muzzle, and one cat had nasal discharge for 2 days. No major complications occurred during the healing process, and all cats went on to achieve successful healing of their flap. A small area of partial-thickness necrosis developed at the cranial edge of the flap in three cats and healed spontaneously in all cases within a few days. According to owner satisfaction and periodic clinical assessment, cosmetic and long-term functional of outcomes were considered good in all cats. CONCLUSION: The lip-to-nose flap allowed for aesthetic and functional reconstruction of the nasal planum after curative intent surgical excision of feline SCC. CLINICAL SIGNIFICANCE: The lip-to-nose flap is an option for a single-stage reconstruction of the nasal planum following partial nasal planectomy in cats.
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Carcinoma de Células Escamosas/veterinária , Face/cirurgia , Neoplasias Nasais/veterinária , Procedimentos de Cirurgia Plástica/veterinária , Retalhos Cirúrgicos/veterinária , Animais , Carcinoma de Células Escamosas/cirurgia , Gatos/cirurgia , Feminino , Humanos , Lábio/cirurgia , Masculino , Nariz/cirurgia , Neoplasias Nasais/cirurgia , CicatrizaçãoRESUMO
Pheochromocytoma is frequent in dogs and carries a guarded prognosis. Current histological criteria may not predict malignant behavior in dogs, similar to humans. In humans, characterization of tumors has been refined using the pheochromocytoma of the adrenal gland scaled score (PASS) and by immunohistochemistry. The study aim was to investigate PASS and immunohistochemical markers used in humans in 24 dogs with pheochromocytoma that underwent adrenalectomy. Dogs with pheochromocytomas were reviewed and tumors collected. Histological sections were evaluated to apply the PASS and were single-labeled for chromogranin A, Ki-67, COX-2, p53, BCL-2, c-erbB-2, vascular endothelial growth factor, and S100. Survival, age, and vascular and capsular invasion were compared for PASS and immunohistochemical markers; results of PASS were also compared for each marker. Associations between markers were tested. PASS and immunohistochemical markers did not differ for survival, age, and vascular and capsular invasion. Tumors showing BCL-2 expression in >50% cells had lower PASS than those with lower expression (PASS: 7 ± 2 vs 9 ± 2; P = .011). Tumors positive for S100 had higher PASS than those that were negative (PASS: 10 ± 2 vs 7 ± 2; P = .001). Results of the different markers were not associated. In conclusion, in the context of canine pheochromocytoma, PASS and the selected immunohistochemical markers are not associated with survival, age, or vascular or capsular invasion. The higher PASS in S100-positive tumors may indicate that pheochromocytomas developing morphologic changes acquire S100 expression. The significance of lower PASS in tumors with elevated BCL-2 expression is uncertain. Overall, the use of PASS and the present immunohistochemical markers may not be useful in dogs with pheochromocytoma.
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Neoplasias das Glândulas Suprarrenais/veterinária , Adrenalectomia/veterinária , Doenças do Cão/cirurgia , Feocromocitoma/veterinária , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/patologia , Animais , Biomarcadores Tumorais , Doenças do Cão/diagnóstico , Doenças do Cão/patologia , Cães , Feminino , Masculino , Feocromocitoma/diagnóstico , Feocromocitoma/patologia , Feocromocitoma/cirurgia , PrognósticoRESUMO
BACKGROUND: Peripheral neuroblastic tumours arising from primitive cells of the cranial and spinal ganglia and from sympathetic ganglion cells of the autonomic nervous system include, from most to least differentiated, ganglioneuroma, ganglioneuroblastoma and neuroblastoma. Canine ganglioneuroblastoma has been described in the mediastinum, nasal and oral cavities, as well as in the brain. OBJECTIVE: To describe the clinical and histopathological findings, treatment and follow-up of a primary cutaneous ganglioneuroblastoma affecting the footpad of a dog. ANIMAL: An 8-year-old male German shepherd dog, referred for left forelimb lameness and licking of the footpad, showed thickening of the footpad of digit V with a central nodular lesion. METHODS AND RESULTS: Histopathological and immunohistochemical examination on a surgical skin biopsy specimen showed an infiltrative and highly cellular neoplasm in the deep dermis. The neoplasm was composed of large polyhedral cells with abundant cytoplasm containing Nissl substance that reacted strongly with neuron-specific enolase and neuronal nuclei antigen, spindle cells with indistinct cell borders suggestive of Schwann cells, with a mild S-100 and GFAP immunoreactivity, and rare nests of neuroblasts. The owner agreed to digit amputation. Histologically, a neoplastic multinodular proliferation with morphological findings like those detected in the biopsy was observed, not extended to the surgical margins and without involvement of skeletal bone. No recurrence or metastasis was observed over a period of one year. CONCLUSIONS AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is the first report of a primary cutaneous ganglioneuroblastoma in a dog. Ganglioneuroblastoma should be included in the differential diagnoses of canine footpad neoplastic diseases.
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Doenças do Cão/diagnóstico , Pé/patologia , Ganglioneuroblastoma/veterinária , Animais , Biópsia , Diagnóstico Diferencial , Cães , Ganglioneuroblastoma/diagnóstico , Masculino , Pele/patologiaRESUMO
OBJECTIVE: To describe the clinical characteristics, perioperative complications, and outcomes in dogs surgically treated for gastric carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Forty client-owned dogs with histologically confirmed gastric carcinoma. METHODS: Medical records were reviewed for preoperative diagnostics, surgery, histopathology, postoperative complications, adjuvant chemotherapy, disease progression, and survival. Variables were assessed for associations with outcome by using Cox proportional hazards regression analysis. RESULTS: Surgical treatment included partial gastrectomy (28 dogs), Billroth I (9 dogs), subtotal gastrectomy (2 dogs), and submucosal resection (1 dog). Major postoperative complications occurred in 8 of 40 dogs, including septic peritonitis secondary to dehiscence in 4 dogs. The median progression free interval was 54 days, and the median survival time (MST) was 178 days (range, 1-1902). According to multivariable analysis results, experiencing an intraoperative complication was associated with an increased risk of death (hazard ratio [HR] 3.5, 95% CI 1.1-9.8, P = .005), and administration of adjuvant chemotherapy correlated with an improved survival (HR 0.4, 95% CI 0.2-0.9, P = .03). CONCLUSION: In this population of dogs, MST exceeded historically reported data, major postoperative complication rates were comparable to established literature, and administration of adjuvant chemotherapy was associated with improved survival. CLINICAL SIGNIFICANCE: Results from this study may be used to counsel owners more accurately regarding prognosis for dogs undergoing surgical excision for gastric carcinoma.
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Carcinoma/veterinária , Doenças do Cão/cirurgia , Complicações Intraoperatórias/veterinária , Complicações Pós-Operatórias/veterinária , Sociedades Veterinárias , Neoplasias Gástricas/veterinária , Animais , Carcinoma/cirurgia , Quimioterapia Adjuvante , Cães , Feminino , Masculino , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: To describe a local interpolation flap based on the upper lip for the reconstruction of the dorsal aspect of the nasal plane in dogs. STUDY DESIGN: Ex vivo and in vivo case report. ANIMALS: A 2-year-old medium-sized spayed female mixed-breed dog and a canine cadaver of a medium-sized mixed-breed dog. METHODS: A dorsal defect of the nasal plane of uncertain origin in a dog was reconstructed with a unilateral interpolation flap obtained from the caudal upper lip skin and mucosa (lip-to-nose flap). The procedure was first performed in a cadaveric model to assess its feasibility. RESULTS: The lip-to-nose flap allowed the reconstruction of a dorsal nasal plane defect with a satisfactory cosmetic outcome. The incorporation of the labial mucosa guaranteed a complete and uncomplicated wound healing of the flap; a small area of necrosis occurred at the donor site, which resolved in a few days. CONCLUSION: The use of a lip-to-nose flap was feasible in these 2 medium-sized dogs and led to satisfactory cosmetic outcome. CLINICAL SIGNIFICANCE: A lip-to-nose flap may be considered to reconstruct dorsal nasal plane defects in dogs and allows for a cosmetic outcome.
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Cães/lesões , Lábio/cirurgia , Nariz/lesões , Procedimentos de Cirurgia Plástica/veterinária , Retalhos Cirúrgicos/veterinária , Ferimentos e Lesões/veterinária , Animais , Cadáver , Cães/cirurgia , Estudos de Viabilidade , Feminino , Nariz/cirurgia , Ferimentos e Lesões/cirurgiaRESUMO
OBJECTIVE: To describe the frequency and extent of complications associated with lateral caudal axial pattern flaps used to cover large traumatic or excision skin defects on the dorsum, gluteal, and perineal region in 13 dogs. STUDY DESIGN: Case series. ANIMALS: Thirteen client-owned dogs. METHODS: Medical records from 8 institutions were reviewed for dogs treated with a lateral caudal axial pattern flap, including cases in which the procedure was combined with other reconstructive techniques. The flap length relative to the tail length, location of tail skin incision, size and cause of the defect, and short- and long-term complications were recorded. RESULTS: Thirteen dogs were included, 11 with tumors and 2 with traumatic skin loss. The mean estimated length of the flap relative to tail length was 51% (range 33-70%). Four dogs had wound complications. This included 2 dogs with minor postoperative wound complications (mild distal dehiscence) that did not require surgical revision and 2 dogs with major complications that required surgical revision. Two of these 4 dogs had distal flap necrosis, one was revised surgically and one was managed conservatively. In these 2 dogs, the flap length was estimated as 80% and 65% of the tail length, respectively. At 30 days, flaps in all dogs were completely healed. No long-term complications were recorded in any dog. For some dogs, the reconstruction was not obvious, with only the change in hair direction and color noticeable. CONCLUSION: Lateral caudal axial pattern flap is a reconstructive option for gluteal, dorsal, and perineal skin defects in dogs. Distal flap necrosis and dehiscence due to wound infection occurred in 4 dogs that required additional wound care but not always surgical revision.
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Doenças do Cão/cirurgia , Cães/lesões , Retalhos Cirúrgicos/veterinária , Animais , Nádegas/cirurgia , Feminino , Masculino , Períneo/cirurgia , Complicações Pós-Operatórias/veterinária , Período Pós-Operatório , Estudos Retrospectivos , Pele/lesões , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/veterinária , Deiscência da Ferida Operatória/veterinária , Resultado do Tratamento , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/veterináriaRESUMO
OBJECTIVES: Keyhole gastropexy is becoming increasingly popular, and the new development facilitates shorter surgical times. This paper reports on the learning curve in two-port laparoscopic gastropexy using FlexDex in a specialist's hands. FlexDex is a novel tool combining aspects of robotic surgery without requiring an expensive robot theatre setting. METHODS: Cohort of 16 dogs >25 kg and at high risk of gastric volvulus and dilatation (GDV) undergoing elective laparoscopic gastropexy were enrolled in the study consecutively from 5/2022 to 9/2023. All patients were operated on by one surgeon (FM), and surgical time was recorded to assess learning curve. Competence was defined as plateauing surgical time. Detailed follow-up at 1 day, 7 days, 14 days, 2 months, 6 months, and long-term was recorded for success rate and complications. Ultrasound examination was scheduled at 4-6-month review to confirm lasting success of the gastropexy. RESULTS: All 16 patients were operated on successfully without any significant complications, as confirmed on the ultrasound. The surgical time of laparoscopic gastropexy reduced from 52 to 14 min (reduction of 38 min/73%) and reached plateau after the 12th case of the 16, making it a very steep learning curve in specialist hands. There were no serious complications, and success rate was 100% at the 6-month ultrasound assessment. CLINICAL SIGNIFICANCE: This is the first paper to report on the learning curve with the FlexDex device in a two-port laparoscopic gastropexy setting. It effectively halves the operating time to 30 min, making the surgery safer for the patient and more cost-efficient, without compromising the result.
RESUMO
A 5-year-old spayed female Breton dog was referred for a thyroid nodule. A total body CT scan evidenced multifocal hepatic nodules. Cytological liver samples were hemodiluted and non-diagnostic. Following a thyroidectomy, the histology was consistent with a follicular-compact thyroid carcinoma. On laparoscopy, most hepatic lobes had multifocal dark-red nodules that were biopsied for histology. Microscopically, the hepatic parenchyma in the nodules was substituted by blood channels lined by bland spindle cells but adjacent to epithelioid neoplastic cells, single or in clusters, embedded in a moderate amount of edematous collagen matrix. These cells had optically empty cytoplasmic space, occasionally containing erythrocytes (microlumina). Spindle and epithelioid cells expressed membranous-to-cytoplasmic CD31 and FVIII-RA consistent with endothelial origin. Based on morphology and immunolabelling, a hemangioendothelioma with epithelioid differentiation was diagnosed. Lesions in the liver were initially stable, showing progression with time. The dog was alive with no systemic clinical signs 36 months after laparoscopy.
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OBJECTIVE: To report and evaluate risk factors for conversion and perioperative and long-term outcomes in dogs undergoing thoracoscopic lung lobectomy for resection of lung masses. ANIMALS: 61 client-owned dogs. METHODS: This retrospective cohort study (June 11, 2008, to February 14, 2020) of data collected from medical records included signalment, results of diagnostic imaging, surgical technique, surgical and anesthesia time, mass location and size, hospitalization time, histopathologic findings, and long-term outcome. Follow-up was obtained from medical records and telephone contact with owners or referring veterinarians. RESULTS: Histopathology results were available for 60 of 61 tumors. Fifty-seven (95%) were considered primary lung tumors, of which 46 (81%) were carcinomas. Clean surgical margins were achieved in 46 of 52 (88%) dogs. Conversion from thoracoscopy to thoracoscopic-assisted or open surgery occurred in 16 of 61 (26%) dogs. Larger tumor diameter (≥ 5 cm) and lymphadenopathy detected by preoperative CT scan were significantly associated with increased risk of conversion. There was no association between conversion and patient weight, body condition score, and tumor location. All 61 dogs survived to discharge, and 56 of 57 were alive 1 month postoperatively. Median overall survival time was 311 days (95% CI, 224 to 570 days). Tracheobronchial lymphadenopathy on preoperative CT scans was associated with shorter postoperative survival (P < .001). Patient age, tumor diameter, adjuvant chemotherapy following surgery, and incomplete margins were not associated with survival time. CLINICAL RELEVANCE: Dogs had high survival to discharge and good long-term prognosis following thoracoscopic lung lobectomy. However, larger tumor size and tracheobronchial lymphadenopathy may increase the likelihood of conversion.
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OBJECTIVE: To report the perioperative outcome and complications in cats undergoing minimally invasive splenectomy. ANIMALS: 17 client-owned cats. METHODS: Perioperative data were collected from cats undergoing minimally invasive splenectomy from September 2010 to June 2023. Data included history, signalment, preoperative examination and diagnostic testing results, operative technique and time, perioperative outcomes, complications, hospitalization duration, histopathological diagnosis, and outcome. RESULTS: 13 spayed females and 4 neutered males were included, with a median age of 144 months (48 to 196 months). Seven cats underwent total laparoscopic splenectomy (TLS), with 1 cat requiring conversion from TLS to laparoscopic-assisted splenectomy (LAS) due to splenomegaly and an additional cat requiring conversion from TLS to open splenectomy due to uncontrollable splenic capsular hemorrhage. Ten cats underwent LAS, with 1 cat requiring conversion to open splenectomy due to splenomegaly. Additional procedures were performed in 13 cats, with the most common being liver biopsy in 10 cats. Median operative times were 50 minutes (45 to 90 minutes) for TLS and 35 minutes (25 to 80 minutes) for LAS. An intraoperative complication occurred in 1 cat. All but 1 cat survived to discharge. Median follow-up time was 234 days (18 to 1,761 days), with 15 of 16 cats confirmed alive at 30 days and 9 of 16 cats alive at 180 days postoperatively. CLINICAL RELEVANCE: Minimally invasive splenectomy in this cohort of cats was associated with short operative times and a low perioperative complication rate. Veterinary surgeons may consider minimally invasive splenectomy as an efficient and feasible technique in the treatment of splenomegaly or modestly sized splenic masses for diagnostic and therapeutic purposes in cats.
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Doenças do Gato , Laparoscopia , Humanos , Masculino , Feminino , Gatos , Animais , Esplenectomia/efeitos adversos , Esplenectomia/veterinária , Esplenomegalia/veterinária , Duração da Cirurgia , Resultado do Tratamento , Baço/patologia , Laparoscopia/efeitos adversos , Laparoscopia/veterinária , Laparoscopia/métodos , Estudos Retrospectivos , Doenças do Gato/cirurgia , Doenças do Gato/patologiaRESUMO
Osteosarcoma is the most common malignant primary bone cancer, but it is infrequently reported in cats. Feline appendicular osteosarcoma typically exhibits good prognosis when treated with surgery alone. A retrospective multi-institutional study was conducted to identify possible prognostic factors. Cats diagnosed with appendicular osteosarcoma were included if initial staging and follow-up information were available. Data including signalment, tumour characteristics, treatment modalities, and survival outcomes were collected and analysed. Fifty-six cats were included; the femur was the most frequently affected bone. Eight cats had distant metastasis at admission and an additional 9 developed metastatic disease during follow-up, resulting in an overall metastatic rate of 30%. Forty-nine (87.5%) cats underwent surgery, and 4 also received adjuvant chemotherapy. Among operated cats, median time to local progression (TTLP), time to distant progression and tumour-specific survival (TSS) were not reached. One- and 2-year survival rates were 66% and 55%, respectively. Seven (12.5%) cats received no treatment; 1- and 2-year survival rates were 25% and 0%, respectively. Operated cats had significantly longer TTLP (P < .001) and TSS (P = .001) compared with non-operated cats. Among operated cats, young age negatively impacted local tumour progression, while the presence of distant metastasis at diagnosis was associated with a higher risk of tumour-related death. This study reaffirms the good prognosis for cats with appendicular osteosarcoma undergoing surgery, but sheds light on some additional factors to consider. Accurate initial staging is recommended, as the metastatic rate may exceed many previous estimations. Surgery substantially extends survival time, whereas the role of chemotherapy remains uncertain.
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Doenças do Gato , Osteossarcoma , Animais , Osteossarcoma/veterinária , Osteossarcoma/terapia , Osteossarcoma/patologia , Gatos , Doenças do Gato/patologia , Estudos Retrospectivos , Masculino , Feminino , Neoplasias Ósseas/veterinária , Neoplasias Ósseas/patologia , Neoplasias do Apêndice/veterinária , Neoplasias do Apêndice/patologia , ItáliaRESUMO
OBJECTIVE: To report the complications and outcomes associated with thoracoscopic cranial mediastinal mass resection in dogs. ANIMALS: 49 client-owned dogs that underwent thoracoscopic cranial mediastinal mass removal. METHODS: This was a retrospective cohort study (January 1, 2014, to July 31, 2023), and the medical records of 49 client-owned dogs that underwent thoracoscopic cranial mediastinal mass removal were reviewed. The signalment, history, clinicopathologic features, perioperative complications, and long-term outcome were recorded. RESULTS: Preoperative myasthenia gravis (MG) and megaesophagus (ME) were identified in 17 of 49 (35%) dogs and 11 of 49 (22%) dogs, respectively. The median maximal tumor diameter on CT images was 4.7 cm (range, 2.7 to 8.5 cm). Nonemergent conversion to an open procedure was necessary in 4 of 49 (8%) dogs, and dogs with conversion to an open procedure had a significantly larger median maximal CT tumor diameter than dogs without conversion (P = .03). The most common tumor type was thymoma (37/49 [76%]). The overall median survival time for dogs with thymoma was 1,102 days (95% CI, 482 to upper bound not reached). The median survival time for dogs with thymoma and concurrent presurgical MG was 182 days (95% CI, 14 to upper bound not reached). Presurgical diagnosis of MG (P = .44) or ME (P = .69) was not associated with survival time. CLINICAL RELEVANCE: Thoracoscopic removal of cranial mediastinal masses was associated with low conversion and complication rates. Long-term survival is possible, and thoracoscopic removal should be considered for select cases.
RESUMO
BACKGROUND: Few studies have assessed predictors of outcome in dogs with thyroid tumors undergoing thyroidectomy. OBJECTIVE: To estimate the survival and identify prognostic factors in dogs with thyroid tumors treated by thyroidectomy. ANIMALS: A total of 144 client-owned dogs with thyroid neoplasia that underwent thyroidectomy. METHODS: Retrospective study. Data for analysis included hospital attended and year of surgery, signalment, thyroxine concentration, thyroid tumor features (lobe involvement, size, invasiveness, histopathological type), thrombosis, metastasis, additional surgery and therapy, administration of adjuvant chemotherapy. The association of predictors with survival (time from surgery to death) were assessed by calculating cause-specific hazard ratios (HRcs ) and 95% confidence intervals (CI). Causes of death were classified as thyroid-related or because of other cause. RESULTS: Overall median survival time was 802 days (CI95% = 723-1015 days); 89 dogs (77.4%) survived >500 days. Metastases were identified at admission in 12 (8.3%) dogs and were associated with higher thyroid cancer-related fatality (HR = 5.83, CI95% = 1.56-21.78; P = .009). Thrombosis occurred in 40 dogs and was associated with increased risk of death because of other cause (HR = 2.73, CI95% = 1.18-6.35; P = .019). Nonfollicular carcinoma (HR = 4.17, CI95% = 1.27-13.69; P = .018) and administration of chemotherapy (HR = 3.45, CI95% = 1.35-8.82; P = .01) were associated with higher risk of thyroid cancer-related death. CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with thyroid tumors undergoing thyroidectomy have a long life expectancy. Despite the rare presence of nonfollicular carcinoma and metastases, thyroidectomy should still be considered in some of these dogs.
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Carcinoma , Doenças do Cão , Neoplasias da Glândula Tireoide , Cães , Animais , Tireoidectomia/veterinária , Resultado do Tratamento , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/veterinária , Análise de Sobrevida , Carcinoma/cirurgia , Carcinoma/veterinária , Prognóstico , Doenças do Cão/patologiaRESUMO
OBJECTIVE: To report perioperative characteristics and outcome following bilateral, single-session, laparoscopic adrenalectomy (BSSLA) in dogs. ANIMALS: Client-owned dogs (n = 6). CLINICAL PRESENTATION AND PROCEDURES: Medical records were reviewed and perioperative data collected, including preoperative diagnostic imaging, operative details, complications, and need for conversion to open laparotomy. Bilateral, single-session, laparoscopic adrenalectomy was performed on the right or left side with a standard 3- or 4-portal transperitoneal technique. The dog was repositioned to contralateral recumbency, and laparoscopic adrenalectomy was repeated. Follow-up information was collected by telephone interviews with the owners and/or referring veterinarian. RESULTS: Median age and weight of dogs were 126 months and 14.75 kg, respectively. Contrast-enhanced CT (CECT) was performed in all dogs. Median maximal tumor diameter was 2.6 and 2.3 cm for the right and left-sided tumors, respectively. Median surgical and anesthesia times were 158 and 240 minutes, respectively. Conversion to open laparotomy was performed in 1 dog following renal vein laceration during initial adrenalectomy. Left adrenalectomy and ureteronephrectomy were performed, and the right adrenal tumor was left in situ. Cardiac arrest occurred in 1 dog following initial adrenalectomy (left); however, the dog was resuscitated successfully, and contralateral laparoscopic adrenalectomy was performed without complication. All dogs survived to hospital discharge. Follow-up ranged from 60 to 730 days (median, 264 days) for dogs that successfully underwent BSSLA. CLINICAL RELEVANCE: BSSLA was associated with favorable outcomes in this cohort of dogs. Laparoscopy may be considered in dogs with bilateral, modestly sized, noninvasive adrenal tumors.