11 research outputs found

    Cervical Laminectomy for the Treatment of Chronic Caudal Cervical Spondylomyelopathy in a Dog

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     Background: Cervical spondylomyelopathy (CSM) is a common disease of the cervical spine, and causes neurogenic disorders commonly diagnosed in large and giant breeds dogs. There are many surgical procedures proposed for the treat­ment of CSM. Although many authors report a high success rate (between 70% and 90%) after surgical procedures, the high number of techniques described reflects the difficulty in treating this disorder. The objective of this paper is to report a case of CSM with chronic ventral compression (intervertebral disc extrusion) that was treated with dorsal decompres­sion, and to demonstrate the effectiveness of the decompressive technique through pre- and post-operative myelograms.Case: A 9-year-old Doberman Pinscher dog weighing 41.8 kg presented due to a history of tetraparesis. Neurological exami­nation did not reveal any alteration in mental status. There was absence of conscious proprioception on the four limbs; the pelvic limbs were more severely affected. Bilateral patellar hyperreflexia and normal flexor withdrawal reflex were observed on the hind limbs. There was decreased flexor withdrawal reflex and increased extensor tone on the forelimbs. The patient exhibited pain during caudal cervical palpation, and no alterations were seen on the cutaneous trunci reflex. Superficial pain was absent in the hind limbs; forelimbs exhibited presence of motor function with severe paresis. Survey radiographs revealed intervertebral disc space narrowing between C6-C7. A myelogram revealed ventral and dorsal compressions of the spinal cord in the C6-C7 area. Surgical treatment was elected, and laminectomy of the sixth and seventh cervical vertebrae was performed. Improvements were progressive on evaluations made on the seventh, eighteenth, forty-fifth, and sixtieth days after surgery. On the forty-fifth day after surgery, the patient was able to walk with the aid of a support sling, but was incapable of standing and walking without help. Muscle atrophy and paresis progressively improved up to the sixtieth day after surgery, but such improvement was not enough for the patient to get up and walk without the aid of the sling. In view of the evolution of the clinical signs during the post-operative period, another myelogram was performed to check if the extruded intervertebral disc, which was not removed during laminectomy, was still causing spinal cord compression. In comparison to the first myelogram, the compression was significantly attenuated by the surgical procedure. In this examination, the contrast medium columns were minimally compromised by the presence of herniated material; because of that, we opted not to perform a second surgical intervention for removal of herniated disc content.Discussion: Cervical laminectomy is indicated primarily for cases of dorsal compression associated with osteoarthritic changes of facet joints, malformation of the dorsal lamina, or ligamentum flavum hypertrophy however, this technique has also been used to treat ventral compressions, especially if they are multiple. There are no reports of direct comparison between laminectomy and other surgical techniques for the treatment of chronic ventral compressions; consequently, the choice of the technique depends on the surgeon’s experience and preference. Some authors argue that cervical laminec­tomy is not enough to attenuate the compression caused by the disc because this technique does not allow removal of the herniated disc material located ventrally. However, in the case reported here, a comparison between pre- and postopera­tive myelograms revealed that even though the herniated material was not removed, dorsal decompression allowed dorsal dislocation of the spinal cord and, consequently, promoted considerable attenuation of ventral compression.Keywords: Wobbler syndrome, nervous system, spinal cord, cervical vertebrae

    Intermuscular Lipoma in Dogs

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    Background: Lipoma is a benign tumor composed of mature adipose tissue commonly found in subcutaneous tissues. However, eventually, lipomas may be located between the muscle fasciae being classifed as intermuscular lipomas. Complete surgical resection of the tumor mass is indicated as a treatment of affected patients.This report describes fve cases of intermuscular lipoma in dogs, due to the scarcity of data in the literature and lipoma relative importance in the clinical and surgical routine.Case: Five dogs were presented with a history of a large volume in the limbs with progressive growth, suggesting the presence of neoplasia. The frst step was to conduct anamnesis, when the owner reported slow growth, absence of pain, limping and licking of site. No other change was observed upon physical examination. Complete blood count (CBC) as well as liver assessment (FA) and renal (creatinine) were performed in all patients, and the results showed no changes. Fine needle aspiration cytology (FNAC) was performed and showed cells from adipose tissue, followed by histopathological examination of the lesions. Histopathological examination after incisional biopsy of the tumors showed malignancy-freetissue, composed of adipocytes without atypia, interspersed with fbrovascular stroma, confrming the lipoma diagnosis.Intermuscular lipomas were diagnosed in fve dogs with a history of a large volume in the limbs with progressive growth; all of them underwent bloc resection of the tumors. In all cases, the intermuscular lipomatous tumors were well-circumscribed and easily isolated from the tissues.Discussion: Although lipomas are relatively common in older dogs, especially in the subcutaneous tissue, intermuscular subtype is rare in veterinary medicine, which justifes the report of these cases. Intermuscular lipomas account for only 0.3% of the occurrences in human medicine. Morphologically described as tumors of slow and progressive evolution, typically reaching sizes up to 2 cm in humans, the particular cases of tumor masses greater than 5 cm are called giant lipomas. Theslow development of intermuscular lipomas has also been described in domestic animals by, thus corroborating the clini cal history in this work. The intermuscular septum is considered as the origin of intermuscular lipoma, with subsequent development of the adipose tissue between adjacent muscle bundles, thus, resulting usually in well-circumscribed mass of easy surgical divulsion. The morphological characteristics of the resected lipomas, as well as the simple surgical technique corroborate descriptions in the literature. Intermuscular lipomas consist of a challenging diagnosis despite attracting little attention from surgeons. The possibility of the mass being malignant, such as liposarcoma, should also be consideredsince the clinical symptoms consist of swelling of the deep soft tissues. The diagnosis for all these patients was obtained by histopathological examination, since the simple observation of the clinical fndings alone does not support the tumor diagnosis. Lipoma and liposarcoma should be differentiated by cytological and histopathological evaluations of the neoplasia, whereas infltrative lipomas can be diagnosed based on diagnostic imaging methods or even on the fndings during surgery. In this report, specifcally, the fndings during surgery contributed to the differentiation between infltrative and intermuscular lipoma, while for malignancy rating all patients underwent cytological and histopathological evaluations asindicated in the literature. In conclusion, this study demonstrated that complete resection of intermuscular lipoma proved to be an effective treatment to cure the patients.Keywords: benign neoplasm, surgery, resection of intermuscular, canine

    Cervical Laminectomy for the Treatment of Chronic Caudal Cervical Spondylomyelopathy in a Dog

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     Background: Cervical spondylomyelopathy (CSM) is a common disease of the cervical spine, and causes neurogenic disorders commonly diagnosed in large and giant breeds dogs. There are many surgical procedures proposed for the treat­ment of CSM. Although many authors report a high success rate (between 70% and 90%) after surgical procedures, the high number of techniques described reflects the difficulty in treating this disorder. The objective of this paper is to report a case of CSM with chronic ventral compression (intervertebral disc extrusion) that was treated with dorsal decompres­sion, and to demonstrate the effectiveness of the decompressive technique through pre- and post-operative myelograms.Case: A 9-year-old Doberman Pinscher dog weighing 41.8 kg presented due to a history of tetraparesis. Neurological exami­nation did not reveal any alteration in mental status. There was absence of conscious proprioception on the four limbs; the pelvic limbs were more severely affected. Bilateral patellar hyperreflexia and normal flexor withdrawal reflex were observed on the hind limbs. There was decreased flexor withdrawal reflex and increased extensor tone on the forelimbs. The patient exhibited pain during caudal cervical palpation, and no alterations were seen on the cutaneous trunci reflex. Superficial pain was absent in the hind limbs; forelimbs exhibited presence of motor function with severe paresis. Survey radiographs revealed intervertebral disc space narrowing between C6-C7. A myelogram revealed ventral and dorsal compressions of the spinal cord in the C6-C7 area. Surgical treatment was elected, and laminectomy of the sixth and seventh cervical vertebrae was performed. Improvements were progressive on evaluations made on the seventh, eighteenth, forty-fifth, and sixtieth days after surgery. On the forty-fifth day after surgery, the patient was able to walk with the aid of a support sling, but was incapable of standing and walking without help. Muscle atrophy and paresis progressively improved up to the sixtieth day after surgery, but such improvement was not enough for the patient to get up and walk without the aid of the sling. In view of the evolution of the clinical signs during the post-operative period, another myelogram was performed to check if the extruded intervertebral disc, which was not removed during laminectomy, was still causing spinal cord compression. In comparison to the first myelogram, the compression was significantly attenuated by the surgical procedure. In this examination, the contrast medium columns were minimally compromised by the presence of herniated material; because of that, we opted not to perform a second surgical intervention for removal of herniated disc content.Discussion: Cervical laminectomy is indicated primarily for cases of dorsal compression associated with osteoarthritic changes of facet joints, malformation of the dorsal lamina, or ligamentum flavum hypertrophy however, this technique has also been used to treat ventral compressions, especially if they are multiple. There are no reports of direct comparison between laminectomy and other surgical techniques for the treatment of chronic ventral compressions; consequently, the choice of the technique depends on the surgeon’s experience and preference. Some authors argue that cervical laminec­tomy is not enough to attenuate the compression caused by the disc because this technique does not allow removal of the herniated disc material located ventrally. However, in the case reported here, a comparison between pre- and postopera­tive myelograms revealed that even though the herniated material was not removed, dorsal decompression allowed dorsal dislocation of the spinal cord and, consequently, promoted considerable attenuation of ventral compression.Keywords: Wobbler syndrome, nervous system, spinal cord, cervical vertebrae

    Bilateral Double-Pigtail Ureteral Stent Placement for Management of Ureteral Obstruction Secondary to Transitional Cell Carcinoma in a Dog

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    Background: Transitional cell carcinoma (TCC) usually affects the trigone region of the bladder and proximal portion of the urethra. TCC in dogs is often complicated by local tumor invasion and obstruction of the urethra, ureters, or both. Urinary obstruction is the cause of death in approximately 60% of dogs with TCC. Radical surgeries are associated with morbidity and mortality rates. Stents have recently been evaluated for use in dogs with ureteral obstruction resulting from a variety of urinary tract tumors. This report aims to describe bilateral ureteral stent placement for treatment of malignant ureteral obstruction and long-term follow-up in a dog.Case: An 11‐year‐old female spayed Maltese with ureteral obstruction secondary to transitional cell carcinoma (TCC) in the bladder trigone. After palliative debulking procedure and diagnostic of TCC in bladder and NSAIDs treatment, recurrence has occurred causing ureteral obstruction and TCC had invaded the abdominal wall. Abdominal wall local tumor resection, trigone mass debulking and bilateral ureteral stent placement was made. A double-pigtail ureteral stent of appropriate length was advanced to bypass the ureteral obstruction. Stent sizes were 3.5 Fr in diameter and from 8 to 32 cm in length. The patient underwent surgical resection of the transitional cell carcinoma in the abdominal wall. The correct location of the bilateral ureteral pigtail stent was certified by abdominal radiography. Recovery was uneventful and the dog was discharged 2 days after surgery. Eleven months after stent placement, the dog developed lumbar vertebrae metastasis, without evidence of recurrent ureteral obstruction. The owners elected euthanasia 517 days after original presentation and 337 days after ureteral stent placement. Euthanasia was unrelated to the local tumor obstruction but was related to the bone metastasis.Discussion: Ureteral stent placement is feasible techniques for treatment of bladder TCC in dogs, with the objective of delaying the evolution of the disease and preventing ureteral obstruction. According to previous studies, although distant metastatic disease is worrisome, in the majority of dogs with bladder TCC, the primary location of the tumor is the most common cause of death. In patients with ureteral obstruction, early intervention preserves functional renal tissue. Thus, relief of obstruction should be recommended as soon as possible before irreversible renal damage occurs. The authors encourage aggressive and timely intervention, particularly when ureteral obstruction is bilateral. In the present report, 90 days postoperatively local recurrence causing ureteral obstruction was not evidenced on bladder ultrasound images and laboratory test follow-up. After this period, until 180 days after debulking surgery, tumor recurrence occurred, causing clinical signs and compromising renal function. Complications associated with stent placement included stent migration, recurrent ureteral obstruction, stranguria/pollakiuria, presumably due to irritation of the trigonal region from the distal stent; imperfect stent location; ureteral trauma during stent placement; and urinary tract infection. In the present report, the ureteral stents were placed for palliative treatment for malignant ureteral obstructions. Although urinary tract infection was recurrent, other complications associated with bilateral ureteral stent did not occur, such as accidental dislocation or stent obstruction by the tumor. The results obtained were satisfactory for urinary tract obstruction, allowing survival of 517 days. These findings may support long-term ureteral stenting in veterinary patients

    Ureteral Stent Placement Using a Double J-Catheter in the Treatment of Ectopic Ureter in a Dog

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    Background: Ectopic ureter is a congenital anomaly in which the final segment of one or both ureteral orifices is located distal to the bladder trigone. It may be classified as intra- or extramural. Surgical treatment of ectopic ureters in dogs is recommended and the approach varies with the classification. In the postoperative period, complications are common. When stenosis of the new ureteral ostium occurs, immediate repeated surgery is recommended. This study aimed at using the double J catheter placement following neoureterostomy to treat urethral obstruction secondary to the surgical treatment of an intramural ectopic ureter in a dog.Case: An 8-month-old female French bulldog with dysuria and urinary incontinence was seen at a private veterinary hospital in Jaboticabal, São Paulo. The patient had previously been diagnosed with an intramural ectopic ureter on the right side following imaging tests (ultrasound, computed tomography, and abdominal radiography, excretory urography) and had undergone neoureterostomy and closure of the intramural pathway approximately a year ago. Ultrasonographic examination showed dilation of the caudal portion of the ureter and hydroureter, which was suggestive of right ureteral stenosis. Computed tomography was also performed to evaluate the kidneys, ureters, and bladder; an increase in the diameter of the right ureter in its middle portion and close to the bladder triangle was observed. A new surgical intervention was indicated and performed. The ureteral route was identified in a region of the bladder trigone, incised, and probed with a urethral probe No. 04. The intramural course in the proximal urethra was identified and probed with a 16G epidural catheter. It was necessary to perform a neoureterostomy. A longitudinal incision (spatulation) of approximately 5 mm was made in the distal portion of the right ureter to increase the circumference of the anastomosis. The double J 4.7 French (Fr) catheter was inserted through the new ureter ostium into the bladder and advanced into the right kidney in a retrograde manner. Once the proximal end of the double J catheter reached the renal pelvis, the guidewire was withdrawn slowly to allow the catheter to bend in the areas of the renal pelvis and the trigone. The distal end of the double J catheter that extended beyond the bladder lumen was sectioned for better bladder closure. The patient underwent clinical evaluation and laboratory tests (complete blood count and serum creatinine concentration, urine test with bacteriological culture and susceptibility test) 2 weeks after the procedure and, subsequently, every 3 months. Ultrasonography of the urinary tract was performed every 2 months.Discussion: We used a double J catheter in the patient due to a previous obstruction of the ureter ostium after the first surgical procedure. In this way, complications such as postoperative obstructions due to ureteritis and ureteral constriction were avoided and ureteral anastomosis was facilitated. It has been reported that animals subjected to ureteral stent placement have high incidences of dysuria and urinary tract infection, and low incidences of stent migration and occlusion. In this case, no signs of occlusion or obstruction of the implant were identified, but there was a recurrence of urinary tract infections. These frequently cause urethral obstruction associated with the healing of the new ureteral ostium. Patient follow-up and findings associated with the long-term insertion of the double J catheter provide support for the clinical relevance of the present report

    Sugarcane fibre may prevents hairball formation in cats

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    Hair ingested by licking during cat grooming can eventually coalesce into solid masses in cat gastrointestinal tract. It is believed that dietary fibre might reduce formation of these trichobezoars (hairballs). The effects of two insoluble fibre sources added to kibble diets were evaluated with respect to trichobezoar faecal excretion. Thirty-two cats and four diets were used in a randomised block design: a control diet without additional fibre, 10 % added sugarcane fibre, 20 % added sugarcane fibre or 10 % added cellulose. Animals were fed for 42 d and during three separate periods (days 15-17, 25-27 and 40-42), the cats were housed individually in metabolic cages and their faeces were totally collected. The faeces were evaluated and the trichobezoars were isolated and classified into small (2·1 cm). Means were evaluated by repeated measures ANOVA and contrasts (P < 0·05). Cats fed sugarcane fibre shown a linear reduction of small and medium trichobezoar excretion (number per cat per day; P = 0·004) as well as a reduction in trichobezoar mass excretion (mg per cat per day; P < 0·01). The control group showed increased faecal excretion of large trichobezoars (P = 0·003), which were not present in the high sugarcane fibre group (P < 0·006). No effect of cellulose was observed for any evaluated trait. Therefore, long fibres (sugarcane fibre) may cause greater peristaltic stimulation, increasing the propulsion of hair through the gut, but further research is needed to validate this mechanism. In conclusion, sugarcane fibre reduced faecal hairball elimination in cats, which may have clinical applications for the prevention of health problems related to trichobezoars

    Intermuscular Lipoma in Dogs

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    Background: Lipoma is a benign tumor composed of mature adipose tissue commonly found in subcutaneous tissues. However, eventually, lipomas may be located between the muscle fasciae being classifed as intermuscular lipomas. Complete surgical resection of the tumor mass is indicated as a treatment of affected patients.This report describes fve cases of intermuscular lipoma in dogs, due to the scarcity of data in the literature and lipoma relative importance in the clinical and surgical routine.Case: Five dogs were presented with a history of a large volume in the limbs with progressive growth, suggesting the presence of neoplasia. The frst step was to conduct anamnesis, when the owner reported slow growth, absence of pain, limping and licking of site. No other change was observed upon physical examination. Complete blood count (CBC) as well as liver assessment (FA) and renal (creatinine) were performed in all patients, and the results showed no changes. Fine needle aspiration cytology (FNAC) was performed and showed cells from adipose tissue, followed by histopathological examination of the lesions. Histopathological examination after incisional biopsy of the tumors showed malignancy-freetissue, composed of adipocytes without atypia, interspersed with fbrovascular stroma, confrming the lipoma diagnosis.Intermuscular lipomas were diagnosed in fve dogs with a history of a large volume in the limbs with progressive growth; all of them underwent bloc resection of the tumors. In all cases, the intermuscular lipomatous tumors were well-circumscribed and easily isolated from the tissues.Discussion: Although lipomas are relatively common in older dogs, especially in the subcutaneous tissue, intermuscular subtype is rare in veterinary medicine, which justifes the report of these cases. Intermuscular lipomas account for only 0.3% of the occurrences in human medicine. Morphologically described as tumors of slow and progressive evolution, typically reaching sizes up to 2 cm in humans, the particular cases of tumor masses greater than 5 cm are called giant lipomas. Theslow development of intermuscular lipomas has also been described in domestic animals by, thus corroborating the clini cal history in this work. The intermuscular septum is considered as the origin of intermuscular lipoma, with subsequent development of the adipose tissue between adjacent muscle bundles, thus, resulting usually in well-circumscribed mass of easy surgical divulsion. The morphological characteristics of the resected lipomas, as well as the simple surgical technique corroborate descriptions in the literature. Intermuscular lipomas consist of a challenging diagnosis despite attracting little attention from surgeons. The possibility of the mass being malignant, such as liposarcoma, should also be consideredsince the clinical symptoms consist of swelling of the deep soft tissues. The diagnosis for all these patients was obtained by histopathological examination, since the simple observation of the clinical fndings alone does not support the tumor diagnosis. Lipoma and liposarcoma should be differentiated by cytological and histopathological evaluations of the neoplasia, whereas infltrative lipomas can be diagnosed based on diagnostic imaging methods or even on the fndings during surgery. In this report, specifcally, the fndings during surgery contributed to the differentiation between infltrative and intermuscular lipoma, while for malignancy rating all patients underwent cytological and histopathological evaluations asindicated in the literature. In conclusion, this study demonstrated that complete resection of intermuscular lipoma proved to be an effective treatment to cure the patients.Keywords: benign neoplasm, surgery, resection of intermuscular, canine

    Interlocking Nail Combined with Locking Plate Fixation for a Distal Diaphysis Femur Comminuted Fracture in a Dog

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    Background: Interlocking Nail (ILN) is similar a solid intramedullary pins with screws or bolts passing through one and nail holes (locking effect). This implant mostly have been putted normograde, passing by trochanteric fossa of femur, although it is reported to be inserted through the knee, passing by fracture focus and ending close to proximal femur. It is carriedout especially when there is a comminuted fracture in distal third shaft of femur. Locking plate systems work as internal fixators with some advantages compared to conventional plates. It can be used combined with intramedullary pin, and is an effective technique for increase stifeness stabilization of comminuted long-bone fractures, especially for bending. Some studies reported the use of plate-nail to increase even more the stiffness of implants, because of locking screw in plate and nail. Based on the same propose, we aim to report a case of an ILNs normograde (from distal to proximal) connected to a locking plate in highly comminuted distal diaphyseal fracture since it is rarely report in veterinary medicine orthopaedics.Case: A 5-year-old male mixed breed dog was assessed and diagnosed a fracture of the femur in the right pelvic limb. On physical examination, the dog had nonweight bearing lameness in the affected limb and, mobility of the fragments was noted following digital pressure. A comminuted fracture of the distal diaphysis of the femur was identified. A lateral approach tothe shaft of the femur, the incision was extended to the stifle joint through a lateral incision because the fracture seemed to extend throughout the physis. Open but do not touch approach was performed and reduction was gotten without modified environment of fracture hematoma. A surgical drill was inserted through the access in distal extremity of the bone to openthe medullary cavity of the femur. After that, an interlocking nail was inserted into the opening into the distal fragment, the fracture was reduced and the nail was inserted towards the proximal end of the bone. At the next stage the nail was fitted into the medullary canal and it was locked relative to the main fragments of the femur using locking head screws that were anchored in the load carrier of the plate. Postoperative radiographic views documented appropriate implants location and satisfactory femur fracture alignment. At 3 weeks, the patient showed functional use of the limb with partial weight bearing.Discussion: A biomechanical study comparing plate-rod and plate-nail system in gap fractures, showed that maximum load was significant different between the groups, and in plate-nail it was always heavier, it occurs because of the nail bigger diameter and screws pass through nail holes. What prove that this system is stiffer than plate-rod, so because this patient has osteopenia and thin cortical bone like showed previously, we preferred to use nail than intramedullary pin. The ILN could be introduced from proximal to distal femur (antegrade or normograde) and passing through the knee (called in medicine by retrograde, although in veterinary medicine this way is called normograte too), it depends on bone conformation. Several studies used normograde via in femur from distal to proximal, especially in distal fracture. In this case, it was used this via, by the knee, because it would promote better bone stock to insert the screws, since the nail was putted as close as possible from articular surface. In conclusion, the case reported here documented that the combination of a normograde (from distal to proximal) interlock nail with a locking plate provides a rigid fixation method, promoting satisfactory functional recovery time. Further investigations should be performed using plate-nail in vivo to give to us more precise data.Keywords: biological osteosynthesis, canine, orthopaedics, retrograde nail

    Condrossarcoma mixoide em joelho de cão com ruptura do ligamento cruzado cranial - Relato de caso

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    RESUMO. O objetivo do presente relato é descrever um caso de condrossarcoma mixoide em um cão. Foi atendida uma cadela com nove anos de idade da raça Chow-Chow com queixa de claudicação do membro pélvico esquerdo. O paciente foi diagnosticado e encaminhado para tratamento cirúrgico de ruptura do ligamento cruzado cranial esquerdo. Durante a artrotomia para avaliação dos meniscos, observou-se superfície periarticular irregular e rugosa sem notório aumento de volume na região óssea distal do fêmur. Optou-se pela coleta de amostras para análise histopatológica, que revelou a presença do condrossarcoma mixoide. Após 15 dias foi realizada a amputação do membro pélvico esquerdo. Sete meses seguintes da cirurgia, o animal apresentou dificuldade respiratória e hiporexia. Foi realizada radiografia torácica, identificando sinais de metástase pulmonar. Introduziu-se uma sonda esofágica para fazer a alimentação enteral do paciente. Dias após, o animal apresentou piora do quadro clínico e a proprietária optou por não fazer tratamento quimioterápico e sim eutanásia. Apesar de o tratamento cirúrgico ter permitido ao paciente uma boa taxa de sobrevida, não foi suficiente para evitar o desenvolvimento de metástase, o que nos faz considerar que tratamentos adjuvantes como a quimioterapia podem ser necessários. Além disso, ressalta-se a importância de se observar o aspecto macroscópico dos tecidos durante cirurgias ósseas e articulares

    Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit’s model

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    ABSTRACT Purpose: The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed. Methods: Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal. Results: Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique. Conclusions: LC can be performed using different techniques, although the use of EBVS is highly recommended
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