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Maeta et al: Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat
Veterinary Surgery 8, 2022

🔍 Key Findings

  • First reported case of total cystectomy and bilateral cutaneous ureterostomy in a cat using a modified Toyoda technique.
  • Histologically complete tumor resection was achieved, with tumor-free ureter and urethral margins >20 mm.
  • The modified Toyoda technique involved shaping the ureter into a fish-mouth aperture and anastomosing it to a rectangular skin defect for stomal formation.
  • Incontinence was managed using a diaper changed every 6–8 hours, with no dermatological complications.
  • Obstruction of the right ureter occurred 14 months post-op, associated with a subcutaneous nodule at the anastomosis site.
  • Despite incontinence, owner satisfaction and perceived quality of life were high, with the cat living ~16 months post-op.
  • The stents were removed on days 7 (left) and 28 (right) postoperatively, with initial patency maintained until 14 months.
  • This surgical approach may offer palliative or curative benefit for feline trigonal TCC where partial cystectomy is not feasible.

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← Articles

Maeta et al: Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat
Veterinary Surgery 8, 2022

🔍 Key Findings

  • First reported case of total cystectomy and bilateral cutaneous ureterostomy in a cat using a modified Toyoda technique.
  • Histologically complete tumor resection was achieved, with tumor-free ureter and urethral margins >20 mm.
  • The modified Toyoda technique involved shaping the ureter into a fish-mouth aperture and anastomosing it to a rectangular skin defect for stomal formation.
  • Incontinence was managed using a diaper changed every 6–8 hours, with no dermatological complications.
  • Obstruction of the right ureter occurred 14 months post-op, associated with a subcutaneous nodule at the anastomosis site.
  • Despite incontinence, owner satisfaction and perceived quality of life were high, with the cat living ~16 months post-op.
  • The stents were removed on days 7 (left) and 28 (right) postoperatively, with initial patency maintained until 14 months.
  • This surgical approach may offer palliative or curative benefit for feline trigonal TCC where partial cystectomy is not feasible.

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Multiple Choice Questions on this study

In Maeta 2022 et al., on total cystectomy in cats, how long did the cat survive postoperatively before death at home?

A. 6 months
B. 8 months
C. 12 months
D. 16 months
E. 24 months

Answer: 16 months

Explanation: The cat lived for approximately 16 months after surgery despite urinary incontinence and later complications.
In Maeta 2022 et al., on total cystectomy in cats, what describes the surgical modification to the ureter for the stomal anastomosis?

A. Rounded dilation at distal end
B. Fan-shaped incision with flaps
C. Two longitudinal incisions forming a fish-mouth aperture
D. Spatulated end-to-end anastomosis
E. Single central slit

Answer: Two longitudinal incisions forming a fish-mouth aperture

Explanation: This fish-mouth design allowed the ureter to match the rectangular skin defect for secure stoma creation.
In Maeta 2022 et al., on total cystectomy in cats, which surgical method was used to prevent ureteral bending and misalignment during cutaneous ureterostomy?

A. Modified Boari flap technique
B. Traditional end-to-side ureterostomy
C. Modified Toyoda technique
D. Fan-shaped ureterostomy
E. Subcutaneous ureteral bypass

Answer: Modified Toyoda technique

Explanation: The modified Toyoda technique minimized ureteral misalignment by creating a rectangular ureteral stoma and aligning it precisely with the abdominal wall and skin incisions.
In Maeta 2022 et al., on total cystectomy in cats, how was urinary incontinence managed postoperatively?

A. Percutaneous nephrostomy
B. Penrose drain collection bag
C. Urinary catheter tied externally
D. Absorbent diaper changed every 6–8 hours
E. None, incontinence was untreated

Answer: Absorbent diaper changed every 6–8 hours

Explanation: Incontinence was managed successfully using a diaper changed every 6–8 hours, with regular cleaning and ointment.
In Maeta 2022 et al., on total cystectomy in cats, which ureter developed obstruction 14 months postoperatively?

A. Left ureter
B. Right ureter
C. Both ureters
D. Neither ureter
E. Ureter location not reported

Answer: Right ureter

Explanation: A subcutaneous nodule obstructed the right ureter 14 months after surgery, leading to decreased urine output.

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