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ACVS Phase II > Gastrointestinal Surgery > Flashcards

Gastrointestinal Surgery Flashcards

1
Q

Winter, JAVMA, 2017:
Ultrasound vs CT for diagnosing GI obstructions

  1. Abdominal CT diagnosis vs exploratory surgery diagnosis?
  2. Abdominal ultrasonography diagnosis vs exploratory surgery diagnosis?
A

Winter, JAVMA, 2017:

  1. All abdo CT results agreed with ex-lap diagnosis of obstruction
  2. Abdo ultrasound misdiagnosed 1 case with obstruction when it had functional ileus instead
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2
Q

Abrams, Vet Surg, 2019:
Gastric carcinoma in dogs

  1. Post-op complication rate?
  2. % of cases that developed septic peritonitis secondary to dehiscence?
  3. Median progression-free interval?
  4. MST?
  5. Dogs that experience an intra-op complication had increased risk of what?
  6. Effect of adjuvant chemotherapy on survival?
A

Abrams, Vet Surg, 2019:

  1. Post-op complication rate: 20%
  2. 10% developed septic peritonitis secondary to dehiscence
  3. Median progression-free interval: 54 days
  4. MST: 178 days
  5. Dogs that experience an intra-op complication had increased risk of death
  6. Adjuvant chemo was correlated with improved survival
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3
Q

Seim-Wikse, JAVMA, 2019:
Gastric carcinoma in dogs

Factors that make a diagnosis of gastric carcinoma more likely than chronic gastritis?

A

Seim-Wikse, JAVMA, 2019:

Dogs >8 years of age, body condition score <4, serum C-reactive protein concentration >25mg/L, abnormally low serum folate concentration

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4
Q

Tanaka, VRU, 2019:
Contrast-enhanced CT for staging canine gastric tumors

  1. Was post-contrast mean CT attenuation value for lymphoma lower or higher than that for other gastric tumors?
  2. Lymphadenopathy in lymphomas vs adenocarcinomas vs leiomyomas?
  3. Lymph node measurements in lymphoma vs adenocarcinoma?
A

Tanaka, VRU, 2019:

  1. Post-contrast mean CT attenuation value for lymphoma was lower than that for other gastric tumors
  2. Lymphadenopathy was widespread in lymphoma vs regional in adenocarcinoma vs not detected in leiomyomas
  3. Lymph node measurements in lymphoma were larger that those in adenocarcinoma
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5
Q

Smith, JAVMA, 2019:
Small intestinal adenocarcinoma in dogs

  1. Overall MST post-op?
  2. What factor was associated with a longer MST?
  3. What was not associated with survival time?
A

Smith, JAVMA, 2019:

  1. Overall MST post-op: 544 days
  2. Age <8 years was associated with a longer MST
  3. Lymph node metastasis, adjuvant chemo and NSAID administration were not associated with survival time
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6
Q

Tidd, Vet Surg, 2019:
GI lymphoma in cats treated with surgical resection

  1. Distribution of masses with the GIT?
  2. What % survived to discharge?
  3. MST?
  4. What location of masses was associated with a longer survival time?
  5. What surgical factor was associated with survival?
A

Tidd, Vet Surg, 2019:

  1. 58% small intestinal, 23% large intestinal, 19% gastric
  2. 90% survived to discharge
  3. MST: 185 days
  4. Large intestinal masses were associated with longer survival times than small intestinal and gastric masses
  5. Complete surgical excision was positively associated with survival
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7
Q

Andrews, JAVMA, 2018:
Mesenteric volvulus in military working dogs

  1. What % of the dogs died or were euthanized shortly after diagnosis?
  2. Factors associated with increased odds of mesenteric volvulus?
  3. Presence of post-op complications following previous prophylactic gastropexy was associated with development of mesenteric volvulus - true or false?
A

Andrews, JAVMA, 2018:

  1. 93% died or were euthanized
  2. Factors associated with increased odds of mesenteric volvulus: German Shepherd breed, increasing age, history of previous prophylactic gastropexy, history of GI disease, history of other abdominal surgery, and NSAID administration at the time of mesenteric volvulus
  3. True
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8
Q

Plavec, Vet Surg, 2017:
Colonic or ileocecocolic volvulus

What % of affected dogs had previously had surgery for GDV?

A

Plavec, Vet Surg, 2017:

46% of affected dogs had previously had surgery for GDV, suggesting that a motility disorder could be a potential cause

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9
Q

Gremillion, VRU, 2018:
Colonic torsion

What diagnostic test allowed a more definitive diagnosis?

A

Gremillion, VRU, 2018:

Barium enema allowed a more definitive diagnosis

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10
Q

Schwartz and Coolman, Vet Surg, 2018:
Disposable skin staplers for closure of linear GI incisions

  1. Dehiscence rate?
  2. What was found to be associated with incisional dehiscence?
  3. Of the dogs that underwent a second GI surgery for another foreign body, what % had a linear foreign body attached to the staples in the intestinal lumen?
  4. How soon post-op do the skin staples migrate into intestinal lumen, and by when to the staples pass into the fecal stream?
A

Schwartz and Coolman, Vet Surg, 2018:

  1. 1% dehiscence rate
  2. Linear FBs were associated with incisional dehiscence
  3. 20% had a subsequent linear FB attached to the staples in the intestinal lumen
  4. Most of the skin staples will migrate into the intestinal lumen as early as 2 weeks post-op, and pass into the fecal stream by 6 months post-op
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11
Q

Duell, Vet Surg, 2016:
Dehiscence in hand-sutured vs stapled intestinal anastomoses

  1. Overall dehiscence rate?
  2. For hand-sutured anastomoses, what were the dehiscence rates for simple interrupted suture pattern? vs simple continuous suture patterns?
  3. Dehiscence rates for small intestine-small intestine vs small intestine-large intestine vs large intestine-large intestine anastomoses?
  4. Dehiscence rates for hand-sutured vs stapled anastomoses?
  5. What was associated with post-op dehiscence?
A

Duell, Vet Surg, 2016:

  1. Overall dehiscence rate: 14%
  2. 14% dehiscence rate for simple interrupted anastomoses vs 24% dehiscence rate for simple continuous anastomoses
  3. 16% dehiscence rate for small intestine-small intestine vs 4% dehiscence rate for small intestine-large intestine vs 0% dehiscence rate for large intestine-large intestine anastomoses
  4. No difference in dehiscence rates between hand-sutured vs stapled anastomoses
  5. Pre-op septic peritonitis was associated with post-op dehiscence
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12
Q

Snowdon, Vet Surg, 2016:
Dehiscence of FEESA

  1. Dehiscence rate?
  2. Median time to dehiscence?
  3. Dogs with dehiscence were 13 times more likely to have what?
  4. Post-op mortality rate?
  5. Mortality rate in cases with anastomotic dehiscence vs cases without dehiscence?
  6. Surgical factors associated with anastomotic dehiscence?
  7. What 3 factors were not risk factors for anastomotic dehiscence?
A

Snowdon, Vet Surg, 2016:

  1. Dehiscence rate: 11%
  2. Median of 4 days post-op to dehiscence
  3. Dogs with dehiscence were 13 times more likely to have intra-op hypotension
  4. Post-op mortality rate: 28%
  5. 83% mortality rate for cases with dehiscence vs 21% mortality rate for cases without dehiscence
  6. Surgical factors associated with anastomotic dehiscence: presence, duration and number of episodes of hypotension, location of anastomosis involving the large intestine (11 times greater odds of dehiscence)
  7. Pre-op septic peritonitis, presence of a foreign body and hypoalbuminemia were not risk factors for dehiscence
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13
Q

DePompeo, JAVMA, 2018:
Complications of hand-sutured vs stapled intestinal anastomoses

  1. Dehiscence rates for hand-sutured anastomoses vs FEESA?
  2. Mortality rate for patients with dehiscence?
  3. What 3 factors were not risk factors for dehiscence?
A

DePompeo, JAVMA, 2018:

  1. 13% dehiscence rate for hand-suture anastomoses vs 5% dehiscence rate for FEESA
  2. Mortality rate for patients with dehiscence: 69%
  3. Pre-op peritonitis, hypoalbuminemia and anatomic location of the anastomosis were not risk factors for dehiscence
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14
Q

Davis, Vet Surg, 2018:
Dehiscence of enterectomy sites

  1. What % of dogs with pre-op septic peritonitis had hypoalbuminemia vs dogs without pre-op septic peritonitis?
  2. Overall dehiscence rate?
  3. Average time to dehiscence?
  4. Anastomotic technique (stapled vs sutured) was not significantly associated with dehiscence in cases without pre-op septic peritonitis, however in the presence of pre-op septic peritonitis, stapled anastomoses were less likely to dehisce than sutured anastomoses - true or false?
  5. Dogs with pre-op septic peritonitis were how many times more likely to dehisce than dogs without pre-op septic peritonitis?
  6. Mortality rate for dogs with dehiscence?
  7. What was not a risk factor for dehiscence?
A

Davis, Vet Surg, 2018:

  1. 73% of dogs with pre-op septic peritonitis had hypoalbuminemia vs 41% of dogs without pre-op septic peritonitis
  2. Overall dehiscence rate: 11%
  3. Average of 5 days to dehiscence
  4. True
  5. Dogs with pre-op septic peritonitis were 4 times more likely to dehisce than dogs without pre-op septic peritonitis
  6. 67% mortality rate for dogs with dehiscence
  7. Foreign body obstruction was not a risk factor for dehiscence
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15
Q

Sumner, Vet Surg, 2019:
FEESA

Effect of suture reinforcement for FEESA?

A

Sumner, Vet Surg, 2019:

Oversewing the transverse staple line in FEESA was associated with lower dehiscence rates

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16
Q

Gill, JAVMA, 2019:
Dehiscence and mortality rates following GI surgery

  1. What factor(s) were associated with the development of dehiscence?
  2. What factor(s) were associated with death?
A

Gill, JAVMA, 2019:

  1. Dogs with ASA status of 3 or higher were more likely to develop dehiscence
  2. Dogs with ASA status of 3 or higher and dogs with high lactate concentrations were less likely to survive surgery
17
Q

Latimer, JAVMA, 2019:
Large intestinal surgery

  1. Overall dehiscence rate?
  2. Overall mortality rate?
  3. Factors associated with development of dehiscence?
  4. Factors associated with death?
A

Latimer, JAVMA, 2019:

  1. Overall dehiscence rate: 10%
  2. 17% mortality rate
  3. Factors associated with dehiscence: pre-existing colon trauma or dehiscence, pre-existing peritonitis, administration of blood products, administration of >2 classes of antimicrobials, positive microbial culture from a surgical sample, open abdominal drainage
  4. Factors associated with death: pre-op anorexia, hypoglycaemia, neutrophils with toxic changes, administration of pre-op antimicrobials
18
Q

Strelchik, JAVMA, 2019:
Enterotomy for foreign body removal

  1. Dehiscence rate?
  2. Mortality rate for dogs with dehiscence?
A

Strelchik, JAVMA, 2019:

  1. 2% dehiscence rate
  2. 40% mortality rate for dogs with dehiscence
19
Q

Tsuruta, JVECC, 2016:
Jejunostomy tube feeding

  1. Complication rate?
  2. Most common complication?
A

Tsuruta, JVECC, 2016:

  1. 22% complication rate
  2. Most common complication was diarrhea (43%)
20
Q

Risselada, JAVMA, 2018:
Gastrojejunostomy tubes

  1. How much time should be allowed for curing to ensure no leakage?
  2. Why was the combination of a 20Fr G-tube and a 10Fr J-tube not appropriate for clinical use?
  3. What could and could not be administered through the 8Fr J-tube
A

Risselada, JAVMA, 2018:

  1. 12-24 hours for curing; constructs that were allowed to cure for only 6 hours leaked
  2. The combination of a 20Fr G-tube and a 10Fr J-tube is not appropriate for clinical use because no solution could be injected through it due to the outer diameter of the 10Fr J-tube being a similar size to the inner diameter of the 20Fr G-tube
  3. Water and enteral diet could be administered through the 8Fr J-tube but not blenderized canned diet

ACVS Phase II (53 decks)

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