Retrospective comparison of open vs minimally invasive cystotomy in 28 cats using a composite outcome score

Abstract

Objectives The aim of this study was to compare the outcomes of cats undergoing open cystotomy with those undergoing minimally invasive surgery (MIS) for removal of cystic calculi by use of a composite outcome score. Methods Twenty-eight cats were retrospectively enrolled and divided into two groups: open cystotomy (n = 14) and MIS (n = 14). The primary outcome measure was a composite outcome score, including three variables: pain scores ⩾2 at either 6 or 12 h postoperatively; failure to remove all stones as determined by postoperative radiographs; and postoperative complications requiring a visit to the hospital separate from the planned suture removal appointment. Other data collected included signalment, history, other procedures performed during anesthesia, willingness to eat the day after surgery and the financial cost of the procedures. Results There was no significant difference in age, weight, sex or breed between the two groups. The risk of experiencing the composite outcome was 3/14 (21.4%) in the MIS group and 10/14 (71%) in the open procedure group ( P = 0.02). The cats in the open surgery group had 8.3 times greater odds of developing the composite outcome than cats in the MIS group (odds ratio 8.3, 95% confidence interval 1.3–74.4; P = 0.02). In the MIS group, 10/14 cats were eating the day after surgery vs 3/14 in the open procedure group ( P = 0.02). The procedural cost was higher in the MIS group, with a median cost of US$945 (interquartile range [IQR] US$872–1021) vs US$623 (IQR US$595–679) in the open group ( P <0.01). Conclusions and relevance In this study the composite outcome score provided evidence to support the use of MIS techniques in cats with cystic calculi. The composite outcome score should be considered in future veterinary studies as a promising method of assessing clinically relevant outcomes.

Laparoscopic partial pancreatectomy in a cat with exocrine pancreatic carcinoma

“…10 Despite this, cats undergo laparoscopic procedures less frequently than dogs owing to instrumentation and working space challenges in smaller patients. 10,12 Compared with open laparotomy, laparoscopic partial pancreatectomy for the excision of pancreatic adenocarcinoma in humans appears to be associated with shorter operative and recovery time, reduced blood loss, fewer complications and a similar to decreased overall morbidity and mortality. 13,14 An experimental model in dogs revealed quicker recovery of gastrointestinal transit and lower intraoperative cortisol levels in those undergoing laparoscopic partial pancreatectomy compared with open surgery.…”

“…10 Despite this, cats undergo laparoscopic procedures less frequently than dogs owing to instrumentation and working space challenges in smaller patients. 10,12…”

Clinical outcomes of laparoscopic assisted cystotomy in five cats with repeated urethral obstruction

“…Endoscopic assisted surgical techniques are recommended because of their effectiveness in reducing the remaining uroliths in the urethra and bladder and their minimally invasive nature, such as a shorter period of hospitalisation, lower morbidity and reduced postoperative pain. [10][11][12][13][14][15][16] Urolithiasis can be recurrent, and perineal urethrostomy may be indicated in cases where the underlying cause of urolith formation cannot be eliminated or mechanical obstruction is irreversible at the base of the penis (e.g., tissue stenosis or neoplasm). 7,17,18 This case report describes the successful management of urethral obstruction using LAC and postoperative dietary management in five cats with urethral obstruction that reoccurred within 1 week after urethral catheterisation and medical management.…”

3D printed cannulas for use in laparoscopic surgery in feline patients: A cadaveric study and case series

“…While many minimally invasive procedures have been described in veterinary medicine, cats tend to be underrepresented when compared with dogs 1–8 . The small anatomical size of the feline thorax and abdomen, and the resulting limited working space for manipulation of instruments within the body cavity can be difficult to overcome.…”

“…While many minimally invasive procedures have been described in veterinary medicine, cats tend to be underrepresented when compared with dogs. [1][2][3][4][5][6][7][8] The small anatomical size of the feline thorax and abdomen, and the resulting limited working space for manipulation of instruments within the body cavity can be difficult to overcome. Even with the advent of smaller telescopes and instrumentation, manipulation in the abdominal or thoracic cavity remains challenging and various experimental techniques have been evaluated to address this difficulty for use in human patients.…”