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InFocus

A look through the latest literature on soft tissue surgery

A summary of the latest academic publications providing further insight into this month’s spotlight topic: soft tissue surgery

Post-operative complications after mastectomy without perioperative antibiotics

Philip Spåre and others, Swedish University of Agriculture, Uppsala

Mammary tumours account for about half of all malignancies in intact female dogs. Mastectomy is the standard treatment method, but this creates a risk of causing surgical site infections (SSIs). The authors investigated the impact of omitting perioperative antimicrobial prophylaxis on the incidence of SSIs and other post-operative complications. They reviewed the records from 135 procedures carried out on client-owned dogs at three Swedish referral hospitals over a three-year period. The SSI risk was linked to the number of glands involved and the patient’s bodyweight. They conclude that routine antibiotics may be unnecessary in dogs with tumours affecting a single gland.

Acta Veterinaria Scandinavica, 63

Laparoscopic portosystemic shunt attenuation in two cats

Francesca Izzo and others, Apuana Veterinary Clinic, Marina di Carrara, Italy

Portosystemic shunt surgery can be more challenging in feline patients than in dogs due to the smaller size of the vessels involved. Various methods have been described for the gradual attenuation of these abnormalities. The authors describe two cases in which extrahepatic shunts were treated using cellophane banding via a right or left lateral approach. Ultrasonography or CT angiography was used to verify the results of surgery and the success of the procedure in both cases was confirmed by the normalisation of serum bile acid concentrations and clinical signs

Journal of Feline Medicine and Surgery Open Reports, 8, 1-7

Cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs

Kimberly Hooi and others, University of Montreal, Quebec, Canada

Ectopic ureters are a developmental abnormality in which the distal ureter terminates at another site within the lower abdomen rather than the normal position in the trigonal region of the bladder. The authors describe the findings when applying cystoscopic-guided laser ablation (CLA) to treat intramural ectopic ureters. The results in 31 bitches, treated over a 10-year period, show that the technique is helpful in managing incontinence. Those patients still incontinent after CLA procedures may improve with medical management.

Journal of Veterinary Internal Medicine, 36, 156-163

Excision of epithelial rectal masses via a transanal approach

Matteo Cantatore and others, Anderson Moores Veterinary Specialists, Winchester

A range of surgical techniques have been described for the removal of rectal tumours in dogs. Most techniques are highly invasive and the incidence of post-operative complications is considered to be very high. The authors describe the complications and long-term outcomes after submucosal resections in 93 dogs with benign or malignant epithelial rectal masses, treated at seven referral centres in the UK and Italy. In these patients, the incidence of complications was 29 percent and the recurrence rate was 21 percent. Submucosal resection, therefore, appears to be a safe and effective treatment method for epithelial rectal tumours.

Veterinary Surgery, 51, 397-408

Removal of a sewing needle penetrating the foramen lacerum into the brain

Sabrina Abed Alla and others, City Veterinary Hospital, Bergamo, Italy

Intracranial foreign bodies have been described in veterinary literature as a result of the object perforating the oral cavity, nasal cavity or orbits. The authors describe an unusual case in which the object entered the brain via the right foramen lacerum in the middle cranial fossa. The patient was an 11-month-old Cavalier King Charles Spaniel which presented with drooling and chewing. Skull radiographs showed a metallic foreign body, and its position was confirmed with a CT scan. The object was successfully removed surgically with the aid of fluoroscopy and no significant complications were observed.

Journal of Small Animal Practice, 63, 78-81

Purse-string sutures for preventing anal leakage during surgery

Jo Anne Au Yong and Daniel Smeak, Colorado State University, Fort Collins

There is a significant risk of faecal contamination within the aseptic field during veterinary surgical procedures involving the anal region, such as anal sacculectomy or perineal herniorrhaphy. So, at the authors’ institution, anal purse-string sutures are routinely placed preoperatively to reduce the risk of leakage and surgical site infections. They describe a study comparing the resistance to leakage with three different suturing techniques. In tests using canine cadavers, these sutures prevented leakage at normal physiological colonic and rectal pressures, regardless of the technique used.

American Journal of Veterinary Research, 83, 270-274

Update on the diagnosis and treatment of gastric dilatation and volvulus in dogs

Desiree Rosselli, VCA West Los Angeles Animal Hospital, California

Gastric dilatation and volvulus is a life-threatening emergency seen mainly in large, deep-chested dog breeds. It involves the twisting of the stomach on its mesenteric axis causing gastric obstruction, distention and gas accumulation. The author describes current knowledge of the condition and its treatment. She suggests that prophylactic gastropexy should be considered for at-risk breeds. Minimally invasive techniques may reduce surgical time and patient morbidity, and using barbed knotless suture material reduces surgical time compared with traditional sutures with knots.

Veterinary Clinics of North America (Small Animal Practice), 52, 317-337

Outcomes following surgical resection of intracranial meningioma in dogs

Alexander Forward and others, Davies Veterinary Specialists, Hitchin, Hertfordshire

Meningioma is the most common primary brain neoplasm in dogs, but decisions on treatment may be difficult and involve consideration of many different factors. The authors investigated the long-term prognosis in 101 dogs treated surgically at four referral centres and the influence of four different adjunctive therapies. These were an ultrasonic aspirator, hydroxyurea, radiotherapy and topical chemotherapy. Overall, these patients showed excellent outcomes with intracranial surgery though the various adjunctive therapies did not appear to strongly influence survival time.

BMC Veterinary Research, 18

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