Veterinary Surgery最新文献

Objective: To describe a novel surgical technique for the ventral stabilization of the orbit after inferior orbitectomy by using a sling suture and report outcomes in three dogs.

Animals: A 7-year-old male neutered Swiss shepherd, a 4-year-old female neutered golden retriever and a 9-year-old female neutered Rhodesian ridgeback.

Study design: Short case series.

Methods: All dogs presented with caudal unilateral maxillary masses. Surgical resection necessitated a caudal maxillectomy and inferior orbitectomy with a combined dorsolateral and intraoral approach. A sling suture was used to support the globe. A nylon suture was placed rostrally through the osteotomized maxilla and caudally through the osteotomized zygomatic arch via predrilled holes. The suture was tightened until the position of the globe subjectively appeared normal and was secured with a surgeon's knot. The periorbita was secured over the nylon suture with poliglecaprone suture material in a simple interrupted or continuous pattern. The surgical approach was routinely closed.

Results: Follow-up ranged from 7 to 63 days. The surgical wounds healed uneventfully, and no postoperative complications associated with the stabilization technique were noted. No orbital deviation was noted and the zygomatic regions appeared subjectively symmetrical.

Conclusion: The nylon sling suture provided a quick, easy, safe and effective technique to stabilize the ventral orbit during a combined maxillectomy and orbitectomy in dogs.

Objective: (1) Evaluate the accuracy of computed tomography (CT) scans for localization of liver masses. (2) Assess the agreement between radiologists on localization. (3) Determine if location influences the accuracy of localization and histopathologic diagnosis. (4) Determine what lobar vasculature radiologists found most useful for localization.

Study design: Retrospective.

Animals: A total of 67 client-owned dogs with a total of 75 hepatic masses.

Methods: Records were reviewed for relevant data. Localization for each hepatic mass was performed by four radiologists (JH, EH, ML, JF) independently.

Results: Overall accuracy of mass localization was 217/292 (74.3%) by lobe and 264/300 (88%) by division. Accuracy for the quadrate lobe (11/27, 40.7%) was lower (p < .05) than for the caudate process of the caudate lobe (19/24, 79.2%), left medial lobe (47/64, 73.4%) and left lateral lobe (95/101, 89.6%). Accuracy for the right lateral lobe (17/35, 48.6%) was lower (p < .05) lower than for the left lateral lobe (95/101, 89.6%). Accuracy of localization was 173/192 (90.1%) for masses located in the left division, 37/48 (77.1%) in the central division, and 53/60 (88.3%) for the right division. The agreement (kappa) between radiologists was good (0.61-0.8) to excellent (0.81-1) for division and moderate (0.41-0.6) to good for lobe localization.

Conclusion: CT localization was more accurate for division than lobe localization of canine hepatic masses. Similarly, radiologists had a better agreement for division than lobe localization.

Clinical significance: This study supports CT as a useful modality for liver mass localization based on division. CT localization to specific lobes should be interpreted with some caution.

Objective: To assess a three-dimensional (3-D)-printed laryngeal clamp (LC) designed to enhance the anchoring of laryngeal prostheses at the cricoid cartilage.

Study design: Ex vivo biomechanical study.

Sample population: A total of 22 equine larynges.

Methods: Two experimental groups included larynges with standard prosthetic laryngoplasty (PL; n = 10) and larynges with prosthetic laryngoplasty modified with laryngeal clamps (PLLC; n = 10). All constructs underwent 3000 cycles of tension loading and a single tension to failure. Recorded biomechanical parameters included maximum load, actuator displacement, and construct failure. Finite element analysis (FEA) was performed on one PL and one PLLC construct.

Results: The maximum load at single tension to failure was 183.7 ± 46.8 N for the PL construct and 292.7 ± 82.3 N for the PLLC construct (p = .003). Actuator displacement at 30 N was 1.7 ± 0.5 mm and 2.7 ± 0.7 mm for the PL and PLLC constructs, respectively (p = .011). The cause of PL constructs failure was mostly tearing through the cartilage whereas the PLLC constructs failed through fracture of the cricoid cartilage (p = .000). FEA revealed an 11-fold reduction in the maximum equivalent plastic strain, a four-fold reduction in maximum compressive stress, and a two-fold increase in the volume of engaged cartilage in PLLC constructs.

Conclusion: The PLLC constructs demonstrated superior performance in biomechanical testing and FEA compared to standard PL constructs.

Clinical significance: The use of 3-D-printed laryngeal clamps may enhance the outcomes of laryngoplasty in horses. In vivo studies are necessary to determine the feasibility of performing laryngoplasty using the laryngeal clamp in horses.

Objective: To describe a modified closed sacculectomy technique for non-neoplastic anal sac disease in dogs, and to describe the management and short-term outcomes in dogs undergoing sacculectomy by the described technique.

Study design: Retrospective case series.

Sample population: A total of 50 dogs.

Methods: Electronic medical records were reviewed to identify dogs undergoing bilateral anal sacculectomy for non-neoplastic anal sac disease using the described closed technique between January 1, 2013 and February 1, 2024.

Results: A total of 50 dogs underwent bilateral anal sacculectomy for non-neoplastic anal sac disease. Intraoperative anal sac perforation was reported in five dogs (10%). A total of 43 dogs were available for two-week follow-up. Grade 1 complications were reported in 14/43 dogs (32%), grade 2 complications in 2/43 dogs (5%), and grade 3B in 2/43 dogs (5%). At two-weeks postoperatively, 13/14 dogs (93%) had resolution of grade 1 complications. Both dogs with grade 2 complications had resolution reported at two weeks postoperatively, and both dogs with grade 3B complications had resolution reported at two weeks following revision surgery.

Conclusion: Intraoperative complications consisted of anal sac perforation without further complication. Minor postoperative complications were mostly self-limiting, supporting previous literature. Major complications were infrequent and resolved following single revision surgery.

Clinical significance: The technique reported provides an alternative to excise intact and non-neoplastic anal sacs in dogs. The key features of this technique are immediate anal sac identification by following the anatomic path of the duct, minimal peri-saccular dissection, no requirement for packing of the anal sac, and complete removal of the duct and anal sac.

Objective: To provide an overview of available research about effects of horseshoes on equine kinetics and kinematics.

Methods: The terms, "horse/equine," "hoof," "shoes/horseshoes," "kinetics," and "kinematics" were searched in PubMed, Web of Science, Center for Agriculture and Bioscience International, and United States Department of Agriculture National Agricultural Library for manuscripts from first availability to 2024. Independent reviewers used preferred reporting items for systematic reviews and meta-analyses guidelines to map and extract evidence-based data from sources. Metrics included participant demographics, research methods, major findings, and study limitations. Knowledge gaps were also identified.

Results: A total of 46 studies were included. Most utilized non-lame horses to compare original shoe designs or modifications to unshod or a standard open-heel shoe. Horse demographics and gait, study design and outcome measures varied widely. Prevalent data collection equipment included force platforms and pressure plates, wearable force measuring technology, and videography. Many studies reported shoeing effects on limb forces and motion, but there was little consensus among unrelated studies. Common limitations included insufficient data resolution, no randomization, small sample size, single breed, and outcome measures specific or unique to the study. Knowledge gaps included data collection from all limbs and the impact of conformation and limb and hoof morphology and health condition on outcomes.

Conclusion: Information from manuscripts that met inclusion criteria confirmed distinct, variable effects of shoe characteristics on equine gait parameters.

Clinical significance: Details from published work can serve as resource for clinical decisions and to guide standardization among investigations on shoe configuration effects on equine motion.

Objective: The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double-layer end-to-end anastomoses in normal equine descending colon.

Study design: Experimental study.

Sample population: Eight adult horses.

Methods: Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one-layer (n = 12, group 1; continuous Lembert pattern), or two-layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pressures were determined, and location of failure was recorded. Mixed analysis of variance (ANOVA) was employed.

Results: Mean time to completion was decreased (p = .003) in group 1 (18.6 min ± 22.8 s) compared with group 2 (21.35 min ± 22.8 s). Luminal diameter was reduced (p < .0001) in group 2 (47 ± 2.46 mm) compared to group 1 (65 ± 2.77 mm). Location of failure was remote to the anastomosis in all but one segment; therefore, differences in anastomotic bursting pressures could not be determined.

Conclusion: Two-layer closures resulted in significant luminal reduction and took longer to complete than one-layer anastomoses.

Clinical significance: Use of one-layer closures may be advantageous primarily with respect to luminal diameter.

Objective: The aim of the present study was to report the outcomes and complications of minimally invasive tarsal arthrodesis (MITA) in dogs.

Study design: Bi-institutional retrospective study.

Sample population: A total of 15 client-owned dogs.

Methods: Medical records of dogs undergoing MITA were reviewed to determine outcome and complications. Radiographs were recommended every 4 weeks until clinical union and reviewed to evaluate tibiotarsometatarsal alignment, implant position, subsequent osseous union of the debrided articulations. Time to clinical union and complications were recorded. Clinical union was defined as functional weightbearing limb use with at least 50% of osseous union. Final limb function was defined as full, acceptable, or unacceptable.

Results: Partial tarsal arthrodesis was performed in 10 cases and pantarsal arthrodesis in five cases. Postoperative swelling was minimal. Most complications, 26% major and 40% minor, were implant-related, and explant was required in three dogs. No catastrophic complications occurred. Mean (±sd) radiographic follow-up was 11.4 (±13.1) months Mean (±sd) time to radiographic osseous union was 1.8 (±0.5) months. Mean (±sd) time to clinical union was 3.7 (±0.8) months. Physiological alignment was restored in 12/15 dogs. Complete radiographic union occurred in 46% while in the remaining 54% obtained partial radiographic union, but clinical instability was not observed. Limb function was considered full in six and acceptable in eight dogs. Function was unacceptable in one dog, but the cause was not related to MITA.

Conclusion: MITA resulted in restoration of alignment, which was accomplished using MITA techniques. Furthermore, MITA appeared to result in faster healing times and reduced soft tissue complications compared to conventional open approach arthrodesis.

Clinical significance: MITA may be considered as an option to obtain functional arthrodesis in dogs.

Objective: To describe unicondylar humeral fracture (UHF) repair using cannulated transcondylar screws, report postoperative fracture reduction, healing, and complication rates.

Study design: Retrospective.

Animals: A total of 49 client owned dogs with UHF.

Methods: Surgical technique and approach (i.e., open, limited open, or minimally invasive) were recorded. Articular step defect (ASD) and gap (Gap) at the humeral condylar articular surface were measured on pre- and postoperative images and reported as percentages. Fracture healing was graded on follow-up radiographs. Functional outcome was based on client questionnaire over the phone. General linear models were used to assess the impact of surgical approach on %ASD, %Gap, whereas Cox regression was used to assess prognostic factors of full fracture healing.

Results: A total of 49 fractures repaired with a transcondylar screw with or without an antirotational pin(s) were included. Surgical approach did not have an impact on postoperative %ASD, %Gap or development of complications. The overall complication rate was 26% (11/42), with no revision surgery necessary. Of the dogs that encountered complications, 50% required pin and/or screw removal after fracture healing. For 29 dogs with a minimum of four-month owner telephone questionnaire follow-up, 90% reported no lameness and only three reported intermittent lameness. Achieving complete fracture healing was affected by increased postoperative %ASD (p = .033).

Conclusion: The UHFs repaired by transcondylar cannulated screws had acceptable outcomes and fracture reduction with complication rates being similar regardless of the surgical approach.

Clinical significance: Cannulated screws can be implanted with varying surgical approaches to successfully repair UHFs with comparable clinical outcome to previous reports.

Objective: The aim of the present study was to quantify the amount of biologic debris present within disposable bipolar vessel sealing devices after each use for canine splenectomies and determine the aerobic bacterial load of the debris following instrument resterilization with ethylene oxide.

Study design: Prospective observational clinical study.

Study population: Client-owned dogs (n = 40) presenting to a single specialty hospital for open, routine, or emergency splenectomies.

Methods: A total of 16 bipolar vessel sealing devices were randomly assigned to undergo one, two, three, or four splenectomies, manual hand cleanings, and ethylene oxide sterilizations before being dismantled. After final use and sterilization, each handset was agitated in phosphate-buffered saline before disassembly, which was submitted for aerobic culture. Following aseptic disassembly, all biological residue was photo-documented, collected, quantified using a subjective scoring system, and submitted for culture.

Results: Biologic debris was present within the inner mechanics of all devices, specifically under the blade used for vessel transection. A linear increase in debris was not appreciated amongst devices used once versus devices used multiple times. None of the devices nor any of the biologic debris cultured positive following sterilization with ethylene oxide.

Conclusion: The presence of biologic debris was documented after the initial use of disposable bipolar vessel sealing devices, but no devices or debris yielded positive culture results following ethylene oxide sterilization after splenectomies.

Clinical significance: Increased risk of iatrogenic surgical site contamination from reused vessel sealing devices is unlikely when they have been cleaned and sterilized with ethylene oxide after up to four splenectomy surgeries.