Quiz Question

In Monnet 2023 et al., on barbed vs conventional suture in vesicourethral anastomosis (VUA), what was the key finding regarding leakage pressure?

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Correct. The difference in leakage pressure (UBS: 8.6 mmHg vs. C: 11.7 mmHg) was not statistically significant (p = .236).
Incorrect. The correct answer is Leakage pressure was statistically similar.
The difference in leakage pressure (UBS: 8.6 mmHg vs. C: 11.7 mmHg) was not statistically significant (p = .236).

🔍 Key Findings

  • Leakage pressure was not significantly different between unidirectional barbed suture (UBS) and conventional (C) suture groups (p = .236).
  • UBS group had a 28% lower median leakage pressure than the C group (8.6 mmHg vs. 11.7 mmHg), suggesting higher biological risk of leakage.
  • UBS significantly reduced suturing time (median 12.7 vs. 17.3 minutes; p < .0002).
  • Fewer suture bites were needed in the UBS group (median 14 vs. 19; p = .012).
  • No suture breakage or urethral narrowing occurred in either group.
  • Leakage site distribution (ventral vs lateral) was similar between groups; no dorsal leaks noted.
  • Leakage occurred as low as 5 mmHg in UBS group, indicating potential for postoperative extravasation.
  • UBS may aid intracorporeal suturing in minimally invasive prostatectomy, but catheterization remains necessary postoperatively.

Monnet

Veterinary Surgery

5

2023

Influence of conventional versus unidirectional barbed suture on leakage pressures in canine vesicourethral anastomosis: An ex-vivo study

2023-5-VS-monnet-1

Article Title: Influence of conventional versus unidirectional barbed suture on leakage pressures in canine vesicourethral anastomosis: An ex-vivo study

Journal: Veterinary Surgery

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In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, what was the most common location of leakage for skin staple enterotomy (SSE)?

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Correct. All SSE constructs leaked from the center of closure, with immediate leakage in 35%.
Incorrect. The correct answer is Center of closure.
All SSE constructs leaked from the center of closure, with immediate leakage in 35%.

🔍 Key Findings

  • Skin staple anastomosis (SSA) had comparable leak pressures to hand-sewn anastomosis (HSA) but required half the time to complete.
  • Skin staple enterotomy (SSE) had significantly lower leak pressures than hand-sewn enterotomy (HSE) and failed in 12/20 constructs during pressure testing.
  • HSE constructs took 8× longer to complete than SSE, but had much higher intraluminal pressure tolerance.
  • All SSE constructs leaked from the center, with 35% leaking immediately and 60% showing catastrophic failure.
  • SSA leakage occurred at the center in 40% of constructs, likely due to a learning curve in early samples.
  • All constructs had higher pressures than normal physiologic intestinal pressure (4.0 mmHg ±2.0), except some SSEs with immediate leaks.
  • Authors recommend SSA as a viable alternative with appropriate training but do not recommend SSE using the tested technique in live cats.
  • Staple size and placement technique are key factors; smaller or more precisely placed staples may reduce leak risk.

Miller

Veterinary Surgery

4

2024

Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats

2024-4-VS-miller-2

Article Title: Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats

Journal: Veterinary Surgery

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In Bresciani 2022 et al., on modified urethrostomy outcomes, what surgical modification aimed to improve urinary continence?

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Correct. The urethra was tunneled through rectus abdominis muscle to increase resistance and reduce incontinence.
Incorrect. The correct answer is Tunneling through rectus abdominis muscle.
The urethra was tunneled through rectus abdominis muscle to increase resistance and reduce incontinence.

🔍 Key Findings

  • Modified prepubic urethrostomy (mPPU) was effective for managing proximal urethral obstructions in male cats.
  • All 8 cats regained voluntary urination within 24 hours postoperatively.
  • Early urinary incontinence and peristomal dermatitis occurred in all cats but were self-limiting.
  • Two cats (25%) required surgical revision due to stomal obstruction from weight gain and abdominal fat.
  • No intraoperative complications were reported in any of the 8 cats.
  • Follow-up (13–84 months) showed sustained urinary continence and owner satisfaction in all cases.
  • The rectus abdominis muscle tunnel likely increased outflow resistance, minimizing persistent incontinence.
  • Recurrent hematuria and dysuria occurred in 3 cats but were managed conservatively.

Bresciani

Veterinary Surgery

2

2022

Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats

2022-2-VS-bresciani-2

Article Title: Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats

Journal: Veterinary Surgery

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In Marti 2024 et al., on surgical outcomes in feline sialoceles, what was the most common clinical sign on presentation?

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Correct. Over half the cats presented with cervical swelling, making it the most common clinical sign.
Incorrect. The correct answer is Cervical swelling.
Over half the cats presented with cervical swelling, making it the most common clinical sign.

🔍 Key Findings

  • Mandibular and sublingual glands were the most commonly involved salivary glands in feline sialoceles.
  • Left-sided lesions were more prevalent (71%) among affected cats.
  • Ranulae were present in over half (57%) of cases, highlighting the importance of thorough oral exams.
  • Surgical approaches included lateral, ventral, intraoral, or combinations thereof, with no recurrences reported.
  • Marsupialization alone (without gland removal) resolved clinical signs in 4/21 cats, with no short-term recurrence noted.
  • Complications occurred in 5/21 cats (24%), including incisional swelling and one case of feline oral pain syndrome.
  • One cat experienced iatrogenic injury from misidentification of the mandibular lymph node as the gland.
  • Median follow-up time beyond 30 days was 822 days (range: 90–1205), with no long-term recurrences or contralateral lesions observed.

Marti

Veterinary Surgery

7

2024

Outcomes of surgically treated sialoceles in 21 cats: A multi‐institutional retrospective study (2010–2021)

2024-7-VS-marti-4

Article Title: Outcomes of surgically treated sialoceles in 21 cats: A multi‐institutional retrospective study (2010–2021)

Journal: Veterinary Surgery

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In Pilot 2022 et al., on closure methods in sternotomy, what was concluded regarding closure technique choice in large dogs?

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Correct. Dog size increased risk of complications, but closure method did not alter this risk.
Incorrect. The correct answer is Closure material choice does not affect risk in large dogs.
Dog size increased risk of complications, but closure method did not alter this risk.

🔍 Key Findings

  • Overall closure-related complication rate was 14.1%, lower than previously reported (17–78%).
  • No clinically meaningful difference in complication rate between orthopedic wire (17.4%) and suture (11.5%) closure methods.
  • Dog size (≥20 kg) was the only significant risk factor associated with increased closure-related complications (p = .01).
  • Type of closure (wire vs. suture) did not affect risk, even in larger dogs.
  • Suture closure showed a non-significant trend toward fewer complications (mean reduction 2.3%, 95% CI: –9.1% to +4.5%).
  • Most complications were mild (62%), with only 10 severe cases requiring surgical revision.
  • Infection rate was low (2.7%), and not significantly different between wire and suture.
  • Suture closure is a valid alternative to wire, including in large dogs, based on this large, multi-institutional study.

Pilot

Veterinary Surgery

6

2022

Comparison of median sternotomy closure‐related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis

2022-6-VS-pilot-5

Article Title: Comparison of median sternotomy closure‐related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis

Journal: Veterinary Surgery

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In Scott 2023 et al., on thoracoscopic-assisted lung lobectomy, what was the most common **histopathologic diagnosis** among the excised pulmonary lesions?

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Correct. Papillary carcinoma was the most frequent histological diagnosis among dogs undergoing TA lung lobectomy.
Incorrect. The correct answer is Papillary pulmonary carcinoma.
Papillary carcinoma was the most frequent histological diagnosis among dogs undergoing TA lung lobectomy.

🔍 Key Findings

  • TA lung lobectomy was feasible in dogs ≥3 kg, including those with lesions up to 10 cm.
  • 12 intraoperative complications (40%) occurred, with 6 dogs (20%) converted to open thoracotomy, mainly due to adhesions or inability to isolate lobes.
  • Postoperative complications occurred in 8 dogs (27%), most were mild (63%), and only 1 death (3%) was reported.
  • Median hospitalization was 47 hours; 29/30 dogs were discharged successfully.
  • One-lung ventilation (OLV) was attempted in 7 dogs but successfully maintained in only 4.
  • Linear staplers had shorter surgery times (median 57.5 min) than endoscopic staplers (80 min).
  • Histopathology confirmed neoplasia in 77% of cases, most commonly papillary and bronchioalveolar carcinoma.
  • TA lobectomy allows MIS in smaller dogs or with large lesions, avoiding need for full thoracotomy or complex anesthesia/stapling.

Scott

Veterinary Surgery

1

2023

Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs

2023-1-VS-scott-1

Article Title: Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs

Journal: Veterinary Surgery

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In Maeta 2022 et al., on total cystectomy in cats, how was urinary incontinence managed postoperatively?

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Correct. Incontinence was managed successfully using a diaper changed every 6–8 hours, with regular cleaning and ointment.
Incorrect. The correct answer is Absorbent diaper changed every 6–8 hours.
Incontinence was managed successfully using a diaper changed every 6–8 hours, with regular cleaning and ointment.

🔍 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.

Maeta

Veterinary Surgery

8

2022

Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat

2022-8-VS-maeta-5

Article Title: Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat

Journal: Veterinary Surgery

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In Hertel 2025 et al., on portal venotomy for insulinoma, what material and technique were used to close the venotomy site?

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Correct. This closure method minimized bleeding and supported vascular integrity.
Incorrect. The correct answer is 5–0 polypropylene in simple continuous pattern reinforced with tissue glue.
This closure method minimized bleeding and supported vascular integrity.

🔍 Key Findings

  • Portal venotomy enabled successful en bloc resection of a pancreatic insulinoma and associated thrombus in the portal vein, a novel approach in veterinary literature.
  • Temporary portal vein occlusion (15 min) was well tolerated, causing only transient small intestinal congestion without lasting hemodynamic compromise.
  • No intraoperative hemorrhage occurred following vascular isolation and venotomy repair with 5–0 polypropylene in a simple continuous pattern.
  • Postoperative complications were minimal, with only moderate pancreatitis managed medically and no portal hypertension observed on follow-up imaging.
  • Histopathology confirmed insulinoma, with no initial metastasis; CT at 6 months revealed hepatic and peritoneal metastases but no local recurrence at the venotomy site.
  • Portal vein luminal stenosis occurred post-repair but was clinically insignificant.
  • Advanced CT imaging and 3D printed modeling significantly enhanced surgical planning and anatomical assessment.
  • Surgical excision achieved good short-term outcomes, and the dog was alive and euglycemic one year later despite metastatic disease.

Hertel

Veterinary Surgery

5

2025

Successful venotomy for portal tumor thrombus removal due to pancreatic carcinoma in a dog

2025-5-VS-hertel-4

Article Title: Successful venotomy for portal tumor thrombus removal due to pancreatic carcinoma in a dog

Journal: Veterinary Surgery

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In Bresciani 2022 et al., on modified urethrostomy outcomes, what was the reported outcome for voluntary urination post-surgery?

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Correct. Urination resumed within 24 hours in all 8 cats without need for prolonged catheterization.
Incorrect. The correct answer is All cats urinated voluntarily within 24 hours.
Urination resumed within 24 hours in all 8 cats without need for prolonged catheterization.

🔍 Key Findings

  • Modified prepubic urethrostomy (mPPU) was effective for managing proximal urethral obstructions in male cats.
  • All 8 cats regained voluntary urination within 24 hours postoperatively.
  • Early urinary incontinence and peristomal dermatitis occurred in all cats but were self-limiting.
  • Two cats (25%) required surgical revision due to stomal obstruction from weight gain and abdominal fat.
  • No intraoperative complications were reported in any of the 8 cats.
  • Follow-up (13–84 months) showed sustained urinary continence and owner satisfaction in all cases.
  • The rectus abdominis muscle tunnel likely increased outflow resistance, minimizing persistent incontinence.
  • Recurrent hematuria and dysuria occurred in 3 cats but were managed conservatively.

Bresciani

Veterinary Surgery

2

2022

Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats

2022-2-VS-bresciani-3

Article Title: Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats

Journal: Veterinary Surgery

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In Hildebrandt 2023 et al., on Buccal Transposition Flap for Maxillary Lip Reconstruction in Dogs, what was the reported cosmetic and functional outcome of the buccal flap in all 5 dogs?

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Correct. All dogs had satisfactory cosmetic and functional outcomes, despite minor complications in 3 cases.
Incorrect. The correct answer is Good to excellent in all dogs.
All dogs had satisfactory cosmetic and functional outcomes, despite minor complications in 3 cases.

🔍 Key Findings

  • Buccal transposition flap provided successful closure of large maxillary lip defects in all 5 dogs
  • All flaps survived, with 3 dogs experiencing minor complications (e.g., fistulas, dehiscence) that resolved
  • Flap vascularization originated from the angularis oris and superior labial arteries, as confirmed via CT angiography
  • Excellent cosmetic and functional outcomes were achieved in all cases
  • Ex vivo cadaver study validated flap perfusion, showing consistent contrast filling of key arteries
  • Oronasal fistulas occurred in 2 dogs at the palatal incision site, likely due to contact with the mandibular canine tooth
  • Mandibular canine coronectomy was performed in 2/5 dogs to prevent flap trauma
  • Flap design and commissure positioning were customizable, aiding tension relief and improving outcomes

Hildebrandt

Veterinary Surgery

2

2023

Buccal transposition flap for closure of maxillary lip defects in 5 dogs

2023-2-VS-hildebrandt-5

Article Title: Buccal transposition flap for closure of maxillary lip defects in 5 dogs

Journal: Veterinary Surgery

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Quiz Results

Topic: Suture & Soft Tissue Techniques
70%

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