EVALUATING AUTOLOGOUS COMPOSITE COLOPERITONEAL GRAFTS IN THE REPAIR OF URINARY BLADDER DEFECTS IN DOGS

EVALUATING AUTOLOGOUS COMPOSITE COLOPERITONEAL GRAFTS IN THE REPAIR OF URINARY BLADDER DEFECTS IN DOGS

Abstract:

The efficiency of autologous composite colo-peritoneal pedicle grafts in the surgical repair of experimental urinary bladder (UB) defects was evaluated in four Nigerian indigenous dogs (NIDs), age range of 0.75-1 year. Evaluation was done based on demonstration of the suitability of the sero-muscular pedicle flap and peritoneal free flap as composite grafts to repair UB defects.Anatomical evaluations through ultrasonography and radiography of the UB architecture, and histological assessment of the repaired UB tissue were performed.Physiological evaluations werecarried outbased on pre-and post-surgery vital parameters, urinalysis, haematological, serum biochemical, and plasma cytokine assessments. Surgical procedures were performed under general anaesthesia. The dorsal aspect of the UB served as the recipient site, while sero-muscular colonic pedicle flap of the descending colon along with free peritoneal sheath formed a composite tissue (donor). Dextrose, dextrose-saline solution, pentazocine injection and metronidazole infusion were used forpost-surgical management of the dogsfor 5 days. Bland diet was gradually introduced for one week, before resumption ofnormal feeding. There wereslight deviations in vital parameters between pre-surgical and respective post-surgical (first week) values. The base-line rectal temperature(38.6 ± 0.16 oC) wasnot significantly higher than values recorded after the surgery on days 1 (39.23 ± 0.28 oC), 2 (39.23 ± 0.34 oC), 4 (38.78 ± 0.17 oC), and 6(38.83 ± 0.12 oC) post-surgery. Thepre-surgical pulse rateof 105.04 ± 3.26 beats per minute was obtained, andit fluctuated5 days post-surgery within the range values of 106.00 ± 7.12 – 130.00 ± 15.69 beats per minute,but wasnot significant (P > 0.05).The mean pre-surgical respiratory rate(21.36 ± 1.78 cycles perminute)increased relatively post-surgery on days 1, 2 and 3 (34.75 ± 3.86 cycles per minute), (36.00 ± 5.42 cycles per minute) and (26.50 ± 4.72 cycles per minute), respectively. The difference in the values was notsignificant (P > 0.05). Wound adhesion(apposition) of the laparotomy incisions wasobserved between 5 and 15 days viii post-surgery. Post-surgical complications observed were straining, incisional hernia and constipation.Post-surgical cystosonographic assessments on day 8 showed thickened bladder wall at the point of the graft, which decreased markedly on day 21.Cystographic evaluations revealed gradual transition of the UB architecture at the point of graft with clear delineation and minimal blurring at week 2 post-operation,which gradually disappeared at weeks 10 and 14. However, at 108th week post-surgery there was evidence of diverticulum (radiographically and grossly) at the point of patch in one of the subjects, and omental adhesion to the reconstructed site. There was evidence of “graft take” histologically at the site of anastamosis.Post-surgicalurinalysis showed decrease in specific gravity on days 7 (1.006 ± 0.002), 10 (1.005± 0.005)and 13 (1.010 ± 0.004), which fluctuated between 1.008 ± 0.002 and 1.020 ± 0.004 up to the termination of sampling at day 42. Base-line urine pH value(6.81 ± 0.50) fluctuated between 5.75 ± 0.48 and 7.50 ± 0.29 post-surgically. Post-surgical proteinuria was observed for the first 7 days, but disappeared on day 12. Haematuria was observed within the first 16 days post-surgery. The values of the haematological, serumboichemical, plasma cytokines (IL-6 and IL-10) fluctuated immediately post-surgery, but remained within the limits of base-line data (findings) by the end of observation period. In conclusion, autologous composite colo-peritoneal tissue graft wassuccessfuly formed and effectively used in the repair of` extensive urinary bladder defects in dogs

EVALUATING AUTOLOGOUS COMPOSITE COLOPERITONEAL GRAFTS IN THE REPAIR OF URINARY BLADDER DEFECTS IN DOGS

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