Quiz Question

In Drudi 2022 et al., on CAL vs TAL outcomes, what was the approximate mean increase in rima glottidis area at 15 days post-op for the CAL group?

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Correct. CAL maintained a mean 199% increase at 15 days, significantly higher than TAL.
Incorrect. The correct answer is 199%.
CAL maintained a mean 199% increase at 15 days, significantly higher than TAL.

🔍 Key Findings

  • Cricoarytenoid lateralization (CAL) resulted in a significantly greater increase in rima glottidis area at both immediate (205%) and 15-day (199%) time points compared to thyroarytenoid lateralization (TAL) (152% and 127%, respectively).
  • TAL group showed a significant reduction in rima glottidis area between immediate and 15-day postoperative measurements (P < .05), while CAL group had no significant reduction over time.
  • No dogs in either group showed postoperative complications, including aspiration pneumonia, at the 15-day follow-up.
  • All dogs showed improved clinical signs, including decreased stridor and increased exercise tolerance by day 15.
  • CAL produced more stable postoperative glottic area, potentially due to preserved anatomical tension, whereas TAL might experience tension loss due to thyroid cartilage repositioning.
  • Both procedures were technically effective and performed under the same protocol by a single board-certified surgeon.
  • Endoscopic image analysis was used to quantify rima glottidis area, demonstrating a reliable objective method for surgical outcome assessment.
  • Clinical outcome did not differ between groups, despite CAL showing a larger rima glottidis area.

Drudi

Veterinary Surgery

3

2022

Comparison of immediate and short‐term outcomes of cricoarytenoid and thyroarytenoid lateralization in dogs with idiopathic laryngeal paralysis

2022-3-VS-drudi-2

Article Title: Comparison of immediate and short‐term outcomes of cricoarytenoid and thyroarytenoid lateralization in dogs with idiopathic laryngeal paralysis

Journal: Veterinary Surgery

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In Israel 2023 et al., on povidone-iodine lavage, what was the calculated break-even cost for the PrePIL protocol?

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Correct. The break-even cost for PrePIL use was calculated at $49.74, significantly higher than the actual $2.07 cost.
Incorrect. The correct answer is $49.74.
The break-even cost for PrePIL use was calculated at $49.74, significantly higher than the actual $2.07 cost.

🔍 Key Findings

  • No infections (0/102) occurred in cases where preclosure povidone-iodine lavage (PrePIL) was used, compared to 21/2111 (0.99%) with saline lavage.
  • Break-even cost for PrePIL was calculated at $49.74, while the actual cost was only $2.07, confirming strong cost-effectiveness.
  • No adverse reactions or healing complications were reported in the 102 PrePIL cases.
  • The PrePIL protocol used 0.35% povidone-iodine for 3 minutes before closure, followed by sterile saline lavage.
  • Majority of THRs (97%) used cementless fixation (BFX) in PrePIL group; only 3 cases used CFX components.
  • Surgeries followed consistent perioperative antibiotic protocols, making PrePIL the only major protocol variable.
  • Antibiotics were not added to lavage, aligning with WHO and CDC guidelines for antimicrobial stewardship.
  • The infection reduction with PrePIL supports routine use in total hip replacement to reduce periprosthetic joint infections.

Israel

Veterinary Surgery

1

2023

Preclosure povidone‐iodine lavage in total hip replacement surgery: Infection outcomes and cost–benefit analysis

2023-1-VS-israel-2

Article Title: Preclosure povidone‐iodine lavage in total hip replacement surgery: Infection outcomes and cost–benefit analysis

Journal: Veterinary Surgery

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In Fracka 2023 et al., on patient-specific guides, what was a notable advantage of PSGs during surgery?

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Correct. None of the PSGs loosened during surgery, unlike generic guides which may loosen.
Incorrect. The correct answer is No intraoperative guide loosening.
None of the PSGs loosened during surgery, unlike generic guides which may loosen.

🔍 Key Findings

  • 3D-printed patient-specific guides (PSGs) improved tibial cut alignment in the frontal plane compared to generic guides (mean error 1.03° vs 2.41°, p = .036).
  • All tibial cuts using PSGs were within 3° of target alignment, while 2/8 of the generic group were outliers.
  • PSGs significantly improved sagittal alignment of both distal (p = .018) and cranial (p = .043) femoral cuts.
  • No significant difference was found in varus-valgus femoral alignment or closing angle between PSG and generic guide groups.
  • Tibial sagittal slope alignment was not significantly different between groups.
  • PSGs provided better intraoperative usability, including improved visibility, no loosening, and ease of use.
  • Femoral sizing and component fit were equivalent between PSGs and generic guides, ensuring proper prosthesis alignment.
  • PSGs may offer training advantages for novice surgeons, especially in anatomically complex or deformed joints.

Fracka

Veterinary Surgery

5

2023

3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement

2023-5-VS-fracka-3

Article Title: 3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement

Journal: Veterinary Surgery

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In Adams 2022 et al., on C-section survival rates, which factor was most strongly associated with improved neonatal survival?

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Correct. Survival was significantly higher in elective (99.2%) vs emergency (87.1%) C-sections; this was the strongest predictor in multivariable analysis.
Incorrect. The correct answer is Elective vs emergency C-section.
Survival was significantly higher in elective (99.2%) vs emergency (87.1%) C-sections; this was the strongest predictor in multivariable analysis.

🔍 Key Findings

  • Neonatal survival to discharge was 93.1% overall, with no significant difference between brachycephalic (94.8%) and nonbrachycephalic (91.8%) breeds.
  • Elective C-section significantly improved neonatal survival (99.2%) compared to emergency C-section (87.1%) (p < .001).
  • Larger C-section litter size was positively associated with survival (p = .004; OR 1.57), whereas total litter size had no effect.
  • Maternal heart rate and stage of labor were associated with neonatal mortality in univariable analysis, but not multivariable.
  • Brachycephalism alone was not a risk factor for neonatal mortality (p = .221) in multivariable analysis.
  • Emergency C-section was the strongest predictor of neonatal mortality (OR 4.75), regardless of breed.
  • Multidisciplinary team approach likely contributed to high survival rates, emphasizing importance of coordinated care.
  • Historical factors such as primiparity and maternal age were not associated with mortality in this cohort.

Adams

Veterinary Surgery

7

2022

Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section

2022-7-VS-adams-2

Article Title: Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section

Journal: Veterinary Surgery

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In Banks 2024 et al., on CCWO planning accuracy, what was the **mean planned tibial plateau angle (TPA)** using Oxley’s modified method?

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Correct. Mean planned TPA across all groups was 7.6°, exceeding the 5° target.
Incorrect. The correct answer is 7.6°.
Mean planned TPA across all groups was 7.6°, exceeding the 5° target.

🔍 Key Findings

  • Oxley's modified CCWO did not achieve the target TPA of 5° in most cases, even with planning.
  • Mean planned TPA was 7.6°, higher than target, and consistent across dog sizes.
  • Postoperative TPAs were significantly higher in small dogs (median 7°) than in large dogs (median 4.5°).
  • Distalization >7.5 mm of the osteotomy from the patellar tendon led to increased under-correction of TPA.
  • Only dogs with preoperative TPA >35° achieved post-planning TPAs close to the 5° target.
  • Postoperative osteotomy positions were generally more distal than recommended (8.6 mm median).
  • Virtual plate fit was appropriate for all dogs at 5 mm or 7.5 mm positions, suggesting no need for excessive distalization.
  • Excessive correction leading to negative TPAs occurred in some cases, risking caudal cruciate ligament strain.

Banks

Veterinary Surgery

8

2024

A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases

2024-8-VS-banks-1

Article Title: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases

Journal: Veterinary Surgery

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In Farrell 2022 et al., on checklist reliability in OVH simulation, what percentage of checklist items were deemed essential by expert surgical educators?

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Correct. Thirty-nine of 40 checklist items (98%) were validated by expert panel review.
Incorrect. The correct answer is 98%.
Thirty-nine of 40 checklist items (98%) were validated by expert panel review.

🔍 Key Findings

  • 39 of 40 checklist items for simulated OVH surgical assessment had good content validity (CVI = 0.81)
  • Only 1 of 6 items from the OSATS GRS (respect for tissue) met inclusion criteria (CVI = 0.80)
  • Checklist showed strong reliability (G-coefficient = 0.85) for moderate-stakes exams
  • Modified OSATS GRS showed acceptable reliability (G-coefficient = 0.79)
  • Two raters needed for acceptable reliability in high-stakes exams when using the checklist
  • Minimal interrater bias found; variance largely due to interaction among student, rater, and item
  • Digital recordings were a reliable method of evaluating surgical performance
  • Study supports using checklist over OSATS GRS for assessing preclinical students on simulated models

Farrell

Veterinary Surgery

5

2022

Evaluating validity evidence for 2 instruments developed to assess students' surgical skills in a simulated environment

2022-5-VS-farrell-4

Article Title: Evaluating validity evidence for 2 instruments developed to assess students' surgical skills in a simulated environment

Journal: Veterinary Surgery

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In Cola 2024 et al., on laparotomy-assisted endoscopy, what was the overall success rate of LAER in avoiding full conversion to enterotomy or gastrotomy?

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Correct. LAER was completely or partially effective in 35/40 cases (88%).
Incorrect. The correct answer is 88%.
LAER was completely or partially effective in 35/40 cases (88%).

🔍 Key Findings

  • LAER was effective (partial or complete) in 35/40 cases, regardless of FB location or type.
  • Intestinal wall damage significantly increased the likelihood of conversion to enterotomy (p = .043).
  • LAER led to significantly shorter hospitalization (median 48 h vs 72 h; p = .006).
  • Patients in the LAER group required less postoperative analgesia (median 36 h vs 48 h; p < .001).
  • Faster return to spontaneous feeding was seen in LAER group (median 24 h vs 36 h; p = .012).
  • No significant difference in complication rate or postoperative ileus between LAER and enterotomy groups.
  • Sharp, linear, or multiple FBs did not significantly affect LAER effectiveness.
  • Conversion to surgery was required in 5/40 LAER attempts, mostly due to immovable FBs or intestinal damage.

Cola

Veterinary Surgery

7

2024

Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

2024-7-VS-cola-4

Article Title: Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

Journal: Veterinary Surgery

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In Schneider 2025 et al., on axillary LN extirpation, what was a key reason cited for not performing FNA of sentinel ALNs before surgery?

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Correct. FNA of sentinel nodes was avoided to maintain surgical clarity and prevent bruising that could obscure LN identification.
Incorrect. The correct answer is To avoid local hemorrhage and contamination of the surgical field.
FNA of sentinel nodes was avoided to maintain surgical clarity and prevent bruising that could obscure LN identification.

🔍 Key Findings

  • Lateral approach to ALN extirpation was successful in 100% of cases (44 dogs, 48 ALNs) with consistent anatomical landmarks (costochondral junction of rib 1 and caudal scapular edge).
  • Median time for ALN removal was 16.6 minutes, highlighting a fast and efficient dissection method.
  • No intraoperative complications were recorded (e.g., hemorrhage or inability to find the lymph node).
  • Postoperative complications occurred in 18% of cases, including seromas (n=2), wound dehiscence (n=4), lameness (n=1), and discomfort (n=1).
  • Histopathology revealed 56% of ALNs had tumor-related pathology, including overt metastases, early metastasis (HN2), or premetastatic changes (HN1).
  • Normal-sized ALNs (<2 cm) still harbored metastases in 22% of cases, emphasizing the unreliability of size as a staging criterion.
  • False negatives in cytology occurred in 4 cases, underlining the limitations of cytologic evaluation for staging.
  • The technique was reproducible without specialized tools, suggesting wide applicability in general and referral practice.

Schneider

Veterinary Surgery

6

2025

Axillary lymph node removal for staging cancer; description of a lateral approach and application in 44 tumor-bearing dogs

2025-6-VS-schneider-4

Article Title: Axillary lymph node removal for staging cancer; description of a lateral approach and application in 44 tumor-bearing dogs

Journal: Veterinary Surgery

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In Giansetto 2022 et al., on preputial urethrostomy, why was the urethra passed through the linea alba during surgery?

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Correct. Passing the urethra through the linea alba reduced anastomotic tension compared to paramedian tunneling.
Incorrect. The correct answer is To minimize anastomotic tension.
Passing the urethra through the linea alba reduced anastomotic tension compared to paramedian tunneling.

🔍 Key Findings

  • Modified preputial urethrostomy without penile amputation was successfully performed in 4 male dogs with urethral stenosis or trauma.
  • The technique involved anastomosis of the pelvic urethra to the preputial mucosa via caudal celiotomy, avoiding perineal urethrostomy complications.
  • No cases of skin scalding or stoma stenosis were reported during short- and long-term follow-up.
  • Two dogs developed mild urinary incontinence, particularly when excited; one improved with phenylpropanolamine.
  • The approach preserved local anatomy, avoiding penile amputation, osteotomies, and preputial dissection.
  • Postoperative urinary catheterization was used to protect the anastomosis, although optimal duration remains debated.
  • Surgical access via the linea alba minimized tension at the anastomosis site and avoided complications from paramedian approaches.
  • This technique may serve as a viable alternative to prepubic urethrostomy, reducing urine-related skin complications and improving cosmetic outcome.

Giansetto

Veterinary Surgery

8

2022

Preputial urethrostomy with preservation of the local anatomy in 4 dogs

2022-8-VS-giansetto-4

Article Title: Preputial urethrostomy with preservation of the local anatomy in 4 dogs

Journal: Veterinary Surgery

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In Gibson 2024 et al., on mediastinoscopy in dogs, what was the **overall complication rate** observed during the cadaveric procedures?

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Correct. Only minor grade 1 events (pleural tear and LN rupture) were reported, with no major complications.
Incorrect. The correct answer is Low with only two minor adverse events.
Only minor grade 1 events (pleural tear and LN rupture) were reported, with no major complications.

🔍 Key Findings

  • Mediastinoscopy was technically feasible in large-breed canine cadavers using a SILS port and standard laparoscopic instruments.
  • The left tracheobronchial lymph node (LTBLN) was successfully retrieved in all cadavers (7/7), while cranial mediastinal lymph nodes were retrieved in only 1/7.
  • Postprocedural pleural gas was observed in 4/7 cadavers, likely due to CO₂ insufflation.
  • Instrument limitations with a human-designed mediastinoscope led to preference for laparoscopic instruments and SILS port for improved access and visualization.
  • Complication rates were low, with only two minor (Grade 1) adverse events (pleural tear and LN rupture).
  • Obesity and mediastinal fat were cited as potential challenges to visualization and node retrieval.
  • NASA-TLX workload scores were lowest for tracheobronchial nodes, indicating these were the easiest to access.
  • The authors concluded this approach may facilitate minimally invasive biopsy or resection of cranial mediastinal masses in live dogs, but clinical trials are needed to validate safety and efficacy.

Gibson

Veterinary Surgery

5

2024

Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers

2024-5-VS-gibson-4

Article Title: Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers

Journal: Veterinary Surgery

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Quiz Results

Topic: Surgical Techniques & Planning
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