Evaluation of intraluminal pressure in cystorrhaphies with and without intestinal serosal patch supplementation from canine cadavers

Spiller, Paulo Roberto; Gomes, Lianna Ghisi; Monzem, Samuel; Ducatti, Kassia Renostro; Dower, Nathalie Moro Bassil; Pizzinatto, Fábio Dumit; Ribeiro, Alexandre Pinto; Souza, Roberto Lopes de

doi:10.1590/s0102-865020150100000008

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“…The pressure transducer was serially connected to a Passport 12 pressure monitor (Mindray North America, Mahwah, NJ) and zeroed/calibrated at the same level as the bladder at the start of each test. Fluid was infused at a rate of 999 mL/h based on the methods of prior studies (Chu et al, 2020;Duffy et al, 2018Duffy et al, , 2019Hansen & Monnet 2012;Spiller et al, 2015). During fluid infusion, the cystectomy site and urinary bladder surface were monitored for leakage by a single study investigator.…”

Section: Evaluation Of Bladder Leakage and Failure Locationmentioning

confidence: 99%

Influence of three different closure techniques on leakage pressures and leakage location following partial cystectomies in normal dogs

Haas

Duffy

Kendall

et al. 2023

Veterinary Medicine & Sci

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Background: Transitional cell carcinoma (TCC) is the most common neoplasia affecting the canine urinary bladder. Partial cystectomy, when used adjuctively with medical management, has been shown to meaningfully extend medial survival time. Surgical stapling devices have a wide variety of uses and advantages over traditional closure methods and, to date, investigation into their use in canine partial cystectomies has not been documented.Objective: To determine the influence of three closure techniques on ex vivo leakage pressures and leakage location following canine partial cystectomy.Methods: Specimens were assigned to one of three closure techniques: simple continuous appositional closure with 3-0 suture, closure with a 60 mm gastrointestinal stapler with a 3.5 mm cartridge, and placement of a Cushing suture to augment the stapled closure, with each group containing 12 specimens. Mean initial leakage pressure (ILP), maximum leakage pressure (MLP), and leakage location at the time that ILP was recorded were compared between groups.Results: Oversewn stapled constructs leaked at significantly higher ILP (28.5 mmHg) than those in the sutured (17 mmHg) or stapled (22.8 mmHg) group, respectively. MLP was greater in the oversewn stapled construct group compared to other groups. Leakage was detected in 97% partial cystectomies, with leakage occurring from the needle holes in 100% of the sutured closure group, from the staple holes in 100% of the stapled only group, and from the incisional line in 83% and from bladder wall rupture in 8% of the augmented staple closure group. All closure methods withstood normal physiologic cystic pressures.Conclusions: Placement of a Cushing suture to augment stapled closures improved the ability of partial cystectomies to sustain higher intravesicular pressures compared with sutured or stapled bladder closures alone. Further in vivo studies are required to determine the clinical significance of these findings and the role of stapling equipment forThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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