Оглавление
Группа авторов. Veterinary Surgical Oncology
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Veterinary Surgical Oncology
List of Contributors
Preface
Foreword
About the Companion Website
1 Principles of Surgical Oncology
Preoperative Considerations. Signalment
Staging/Concomitant Disease
Neoadjuvant Therapy
Surgical Planning
Fine Needle Aspirate
Biopsy
Pretreatment Biopsy. Needle Core Biopsy
Punch Biopsy
Incisional (Wedge) Biopsy
Excisional Biopsy
Specific Biopsy Techniques. Bone Biopsy
Lymph Node Biopsy
Endoscopic Biopsy
Surgical Considerations for Curative‐Intent Surgery
Defining and Evaluating Surgical Margins
Varying Definitions of “Margin”
The Influence of Sectioning
Future Directions
Palliative and Cytoreductive Surgery
Postoperative Considerations. Tissue Marking
Guidelines for Fixation of Surgical Tissue Specimens
Frozen Sections
Wound Healing
Adjuvant Therapy
References
2 Multi‐modal Therapy
Introduction
Surgery
Radiation Therapy
Surgery and Radiation
Chemotherapy
Electrochemotherapy
Molecular and Targeted Therapies
Complications of Chemotherapy. Chemotherapy Extravasation
Guidelines for Doxorubicin Extravasation
Chemotherapy Effects on Wound Healing
Complications of Radiation Therapy. Radiation Side Effects
Impact of Radiotherapy on Surgical Outcome
Timing of Radiation Therapy Relative to Surgery
Skin Grafts and Flaps in the Radiation Field
Bone Healing and Radiation Therapy
Minimizing the Negative Impact of Radiotherapy on Surgery
References
3 Interventional Oncology
Imaging
Modalities
Contrast Agents
Instrumentation and Implants. Access Needles
Guidewires
Sheaths
Catheters
Vascular Closure Devices
Vascular Occlusion Agents and Devices
Particles
Liquids
Coils
Balloons
Stents
Approaches. Vascular
Natural Orifices
Nonvascular Interventional Oncology Techniques. Stents. Tracheobronchial Neoplasia
Ureteral Neoplasia
Bladder, Urethral, and Prostatic Neoplasia
Colorectal Neoplasia
Esophageal Neoplasia
Biliary Neoplasia
Percutaneous Drainage. Malignant Body Cavity Effusions
Other Drainages
Tumor Ablation
Vascular Interventional Oncology Techniques. Stents
Intraarterial Chemotherapy
Transarterial Embolization and Chemoembolization
References
4 Skin and Subcutaneous Tumors
Skin Tumors General Principles. Introduction. Prevalence
Classification
General Approach to the Diagnosis and Staging of Skin Tumors. Preoperative Assessment. History and Physical Examination
Tumor Staging
Assessment of the Cutaneous Mass
FNA Cytology
Biopsy
Needle Core Biopsy
Incisional Biopsy
Excisional Biopsy
Regional Lymph Node Assessment
Preoperative Diagnostic Imaging
Treatment Options for Skin Tumors
Principles of Surgical Excision
Surgical Margins
Margin Evaluation
Reconstructive Procedures
Adjunctive Therapies for Skin Tumors
Mast Cell Tumors
Clinical Presentation
Diagnosis of MCTs
Clinical Staging
Treatment of Canine Cutaneous MCTs
Surgery. Perioperative Management
Margins. Surgical Margins
Regional Lymph Node Treatment
Anatomical Site Considerations
Prognostic Factors. Histologic Parameters. Grade
Mitotic Index
Proliferation Indices
Clinical Stage
Size
Anatomical Location
Multiple Cutaneous MCT
Subcutaneous MCT
Postoperative Recommendations. Completely Excised MCTs
Incompletely Excised MCTs
Local Tumor Recurrence
Radiation Therapy for MCT
Electrochemotherapy
Chemotherapy for MCT
Combination Chemotherapy
Deionized or Hypotonic Water
Tyrosine Kinase Inhibitors
Feline Cutaneous MCT
Mesenchymal Tumors and Melanoma. Introduction
Soft Tissue Sarcomas
Incidence and Predisposing Factors
Clinical Signs
Metastasis
Diagnostic Strategies and Preoperative Planning
Novel Diagnostic Imaging Techniques
Staging and Grading
Surgical Aspects
Reconstructive Surgery
Cryosurgery
Adjuvant Therapies
Radiotherapy
Chemotherapy
Immunotherapy
Palliative Procedures
Prognosis
Specific Soft Tissue Sarcomas. Fibrosarcomas
Peripheral Nerve Sheath Tumors
Perivascular Wall Tumors
Myxosarcoma
Cutaneous Hemangiosarcoma
Lipoma
Infiltrative Lipomas
Liposarcoma
Lymphangiosarcoma
Leiomyoma and Leiomyosarcoma
Melanoma
Feline Injection‐Site‐Associated Sarcoma (FISAS)
References
5 Head and Neck Tumors
Lymph Node Staging
Nasal Planum Tumors
History and Clinical Signs
Diagnosis and Clinical Staging
Nasal Planum Resection
Surgical Technique
Postoperative Management
Complications
Adjunctive Management
Prognosis
Other Treatment Options. Prevention of Precancerous (Actinic) Lesions
Cryosurgery
Curettage and Diathermy
Radiation Therapy
Photodynamic Therapy
Intralesional Chemotherapy
Tumors of the Pinna
Diagnosis and Clinical Staging
Pinnectomy
Adjunctive Treatment
Tumors of the External Ear Canal
Diagnosis
Treatment
Postoperative Management
Complications
Prognosis
Adjunctive Treatment
Tumors of the Middle Ear
Diagnosis
Treatment
Ventral Bulla Osteotomy
Complications
Prognosis
Salivary Gland Tumors
Diagnosis
Treatment
Prognosis
Tumors of the Lip
Treatment
Postoperative Care
Complications
Prognosis
References
6 Oral Tumors
Introduction
Diagnosis and Clinical Staging. History and Clinical Signs
Diagnosis and Clinical Staging
Diagnosis
Clinical Staging – Local Tumor
Clinical Staging – Regional Lymph Nodes
Clinical Staging – Distant Metastasis
General Surgical Considerations
Antibiotics
Analgesia
Positioning and Preparation
Surgical Considerations
Surgical Approach to Tumors of the Mandible. Anatomy
Rostral Mandibulectomy – Unilateral
Rostral Mandibulectomy – Bilateral
Segmental Mandibulectomy
Rim Mandibulectomy
Subtotal and Total Unilateral Mandibulectomy
Ventral Approach for Segmental, Subtotal Unilateral, and Total Unilateral Mandibulectomy
Caudal (Vertical Ramus) Mandibulectomy
Surgical Approach to Tumors of the Mandible in Cats
Postoperative Management. Analgesia
Nutrition
Complications
Cosmetic Appearance
Eating Difficulties
Incisional Swelling
Ranula‐Like Lesions
Wound Dehiscence
Excessive Drooling
Mandibular Drift and Malocclusion
Miscellaneous Complications
Surgical Approach to Tumors of the Maxilla. Anatomy
Incisivectomy
Rostral Maxillectomy – Unilateral
Rostral Maxillectomy – Bilateral
Rostral Maxillectomy – Bilateral Combined with Nasal Planum Resection
Radical Maxillectomy
Caudal Maxillectomy – Intraoral Approach
Caudal Maxillectomy – Combined Approach
Bilateral Caudal Maxillectomy
Surgical Approach to Tumors of the Maxilla in Cats
Postoperative Management. Analgesia
Nutrition
Miscellaneous
Complications. Cosmetic Appearance
Intraoperative Bleeding
Epistaxis
Eating Difficulties
Wound Dehiscence and Oronasal Fistula
Incisional Swelling
Ulcer Formation Secondary to Trauma by Teeth
Miscellaneous Complications
Mandibular and Maxillary Tumors in Dogs
Oral Tumors in Dogs. Malignant Melanoma
Squamous Cell Carcinoma
Fibrosarcoma
Osteosarcoma
Peripheral Odontogenic Fibroma
Acanthomatous Ameloblastoma
Eosinophilic Granuloma
Oral Tumors in Cats. Squamous Cell Carcinoma
Odontogenic Tumors
Eosinophilic Granuloma
Other Tumor Types
Surgical Approach to Tumors of the Hard Palate. Anatomy
Hard Palate Resection
Postoperative Management and Complications
Surgical Approach to Tumors of the Tongue. Diagnosis and Clinical Staging
Anatomy
Glossectomy
Wedge Glossectomy
Transverse Glossectomy
Longitudinal Glossectomy
Postoperative Management
Complications
Tongue Tumors in Dogs
Tongue Tumors in Cats
Multimodal Management of Oral Tumors. Radiation Therapy
Chemotherapy
Immunotherapy
Prognosis
Malignant Melanoma
Squamous Cell Carcinoma. Canine Oral Squamous Cell Carcinoma
Feline Oral Squamous Cell Carcinoma
Fibrosarcoma
Osteosarcoma
Multilobular Osteochondrosarcoma
Acanthomatous Ameloblastoma
Peripheral Odontogenic Fibroma
Tongue
References
7 Alimentary Tract
Esophagus. Surgical Anatomy and Potential Procedures
Aspiration and Biopsy Principles
Clinical Signs
Diagnostic Tests. Clinical Laboratory Testing
Radiography
Ultrasound
CT and MRI
Esophagoscopy
Surgery. Approach
Techniques
Healing and Complications
Complications
Alternative Techniques
Histologic Tumor Types
Adjuvant Therapies and Outcome
Stomach. Diagnostic Workup and Biopsy Techniques
Technical Aspects of Surgical Procedure. Anatomy
Surgical Procedures. Submucosal Resection
Partial Gastrectomy
Billroth I (Pylorectomy and Gastroduodenostomy)
Billroth II (Gastrojejunostomy)
Complete Gastrectomy
Gastric Lymph Node Dissection
Aftercare
Cosmetic and Functional Outcome
Potential Complications
Common Tumors for Which This Procedure is Performed
Adjuvant Therapies
Liver and Gallbladder. General Operative Considerations
Morphological Classification of Liver Tumors
Diagnostic Workup and Biopsy Techniques
Laparoscopic Biopsy Techniques
Incisional Biopsy and Partial Lobectomy
Complete Lobectomy
Aftercare
Functional Outcome and Complications
Common Tumors for Which This Procedure Is Performed and Prognosis
Hepatocellular
Bile Duct
Carcinoid (Neuroendocrine)
Mesenchymal
Adjuvant and Other Therapies
Pancreas. Pancreatic Anatomy
Pancreatic Vasculature
Imaging of Pancreatic Neoplasia
Ultrasonographic Examination of the Pancreas
Radiographic Examination of the Pancreas
Imaging of Endocrine Pancreatic Tumors. Insulinoma
Glucagonoma
Gastrinoma
Imaging of Exocrine Neoplasia. Carcinoma
Thoracic Imaging for Staging Purposes. Insulinoma
Glucagonoma
Gastrinoma
Carcinoma
Surgical Procedures and Principles. Pancreatic Biopsy
Fine Needle Aspiration
Partial Pancreatectomy
Indications
Total Pancreatectomy
Aftercare
Surgery for Endocrine Pancreatic Neoplasia. Insulinoma
Potential Complications of Surgery for Insulinoma
Prognosis for Insulinoma Treated with Surgery
Gastrinoma
Glucagonoma
Surgery for Exocrine Tumors
Small Intestine. Diagnostic Workup and Biopsy Techniques
Technical Aspects of Surgical Procedure. Anatomy
Technical Options
Simple Interrupted Intestinal Anastomosis
Anastomosis Augmentation Techniques
Aftercare
Functional Outcome – Potential Complications. Dehiscence
Stricture
Recurrence
Mechanical and Physiological Complications
Length Limits to Intestinal Resection
Common Tumors and Prognosis
Adjuvant Therapies
Colorectal Tumors. Clinical Workup and Biopsy Principles
Imaging Techniques. Radiography and Contrast Studies
Ultrasound
Thoracic Radiography
Contrast‐Enhanced CT and MRI
Laparoscopy
Surgical Techniques. Preparation for Colorectal Surgery
Surgical Procedures. Typhlectomy
Potential Complications
Colectomy
Postoperative Care
Potential Complications
Simple Excision of the Mass
Potential Complications
Extent of Resection
Colorectal Resection (Variable Portions of Both Descending Colon and Rectum)
Dorsal Inverted (Dorsal Perineal) Approach
Lateral (Perineal) Approach
Rectal Pull‐Through Procedure
Potential Complications
Extent of Resection
Transanal Pull‐Through Procedure
Postoperative Care
Functional Outcome
Specific Complications
The So‐called Swenson’s Pull‐Through and Modifications
Metastasis Resection
Surgical Palliation
Nonsurgical Treatments
Additional Technical Details for Colorectal Anastomosis
Surgical Stapling
Postoperative Care
Potential Complications
Extent of Resection
Posttreatment Prognosis. Dogs
Cats
Adjuvant Therapies
Perianal Tumors. Surgical Procedures
Clinical Workup and Biopsy Procedures
Imaging Techniques
Surgical Techniques and Procedures
Castration
Cytoreduction or Marginal Excision
Correction of Perineal Hernia
En bloc Excision With or Without Anoplasty
Anal Sac Removal
Resection of Metastases (Metastasectomy)
Postoperative Care
Cosmetic and Functional Outcome
Potential Complications
Common Perianal Tumors and Prognosis
Canine Hepatoid Tumors
Canine Hepatoid Tumors: Histopathologic Features and Prognosis
Anal Sac Adenocarcinoma
Other Perianal Tumors
Adjuvant Therapies
References
8 Respiratory Tract and Thorax
Rhinotomy
Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques
Dorsal Rhinotomy
Ventral Rhinotomy
Lateral Rhinotomy
Temporary Carotid Artery Occlusion
Aftercare
Cosmetic and Functional Outcome
Potential Complications
Common Nasal Tumors
Adjuvant Treatments
Laryngeal Tumors. Biopsy Principles
Imaging Tests
Surgical Techniques. Vocal Cordectomy Laryngectomy
Hemilaryngectomy
Epiglottectomy
Total Laryngectomy
Palliative Surgical Management
Aftercare
Cosmetic and Functional Outcome
Most Common Tumors – Prognosis and Decision‐Making
Adjunctive Therapy
Thoracotomy
Imaging
Surgical Techniques. Intercostal Thoracotomy
Median Sternotomy
Transdiaphragmatic Thoracotomy
Aftercare
Complications and Outcome
Tracheal Tumors. Biopsy Principles
Imaging
Surgical Techniques. Resection and Anastomosis
Surgical Approaches
Quantity of Trachea that Can Be Safely Removed
Tension‐Relieving Techniques
Non‐Surgical Management
Aftercare
Complications
Lung. Surgical Procedures
Surgical Anatomy
Biopsy Procedures
Imaging Tests
Surgical Procedures
Lung Lobectomy
Partial Lobectomy
Complete Lobectomy
Pneumonectomy
Multiple Lung Lobectomies
Thoracoscopy
Metastasectomy
Postoperative Care
Complications of Thoracic Surgery
Types of Lung Tumors
Adjuvant and Alternative Therapy
Prognosis
Metastasectomy for Sarcomas
Time to Detection
Number of Lesions
Doubling Times
Technique
Outcomes after Metastasectomy
Thoracic Wall Resection. Biopsy Procedures
Imaging Tests
Description of Surgical Procedures. Rib Tumors
Invasive Soft Tissue Masses of Tissues Lateral to the Ribs
Reconstruction After Thoracic Wall Resection
Sternectomy
Aftercare
Cosmetic and Functional Outcome
Potential Complications
Common Tumor Types
Adjunctive Therapy
References
9 Cardiovascular System
Heart and Heart‐Base Tumors. Common Surgical Procedures
Biopsy Techniques
Diagnostic Tests and Imaging Modalities
Surgical Techniques
Postoperative Care and Potential Complications
Common Tumor Types, Prognosis, and Adjuvant Therapy
Pericardial Tumors. Common Surgical Procedures
Diagnostic Tests and Imaging Modalities
Surgical Techniques
Common Tumor Types, Prognosis, and Adjuvant Therapy
Carotid Body Tumors
Diagnostic Tests and Imaging Modalities
Surgical Techniques, Potential Complications, and Prognosis
Vascular Oncologic Surgery – Tumor Thrombus Excision
Diagnostic Tests and Imaging Modalities
Surgical Techniques
Postoperative Care and Prognosis
References
10 Reproductive System
Female Reproductive System. Biopsy Techniques
Diagnostic Imaging
Ovarian Tumors
Histologic Tumor Types
Prognosis
Adjuvant Therapy
Uterine Tumors. Surgery
Histologic Tumor Types and Prognosis
Adjuvant Therapy
Vaginal and Vulvar Tumors. Surgery
Episiotomy
Vulvovaginectomy
Histologic Tumor Types
Prognosis
Adjuvant Therapy
Tumors of the Clitoris
Canine Mammary Tumors. Surgery
Lumpectomy
Mammectomy
Regional Mastectomy
Complete Mastectomy
Bilateral Removal of Mammary Glands 4 and 5
Prognosis Based on Extent of Surgery
OHE and Mammary Tumors
Inflammatory Mammary Carcinoma
Histologic Types and Prognosis
Adjunct Therapy
Feline Mammary Tumors. Surgery
OHE and Mammary Tumors
Histologic Tumor Types and Prognosis
Adjuvant therapy
Male Reproductive System. Biopsy Techniques
Diagnostic Imaging
Testicular Tumors. Orchiectomy. Preoperative Considerations
Surgical Decision Making
Histologic Types
Prognosis
Prostatic Tumors. Surgical Considerations
Surgical Techniques and Outcomes. Total Prostatectomy
Subcapsular Partial Prostatectomy
Retained Urethral Catheter after Total Prostatectomy and Subtotal Prostatectomy
Tube Cystostomy
Urethral Stenting
Transurethral Resection
Radiation Therapy
Histologic Tumor Types and Prognosis
Penile Tumors. Surgery. Penile Amputation
Histologic Tumor Types, Prognosis, and Other Treatments
Preputial Tumors
Surgery. Preputial Advancement
Preputial Reconstruction
Histologic Tumor Type and Prognosis
Mammary Gland Tumors in Male Dogs
Mammary Gland Carcinomas in Male Cats
References
11 Urinary Tract
Biopsy Procedures for Urinary Tumors. General Principles
Kidney
Laparoscopy
FNA and Needle Core Biopsy
Incisional Biopsy
Ureter
Bladder. Excisional
Urine Sedimentation
US‐guided Traumatic Catheterization
Cystoscopic Biopsy
BRAF Mutation Test
Urethra. Traumatic Biopsies
Urethroscopic
Imaging Techniques. General Principles of Diagnosis/Staging
Radiography (with or without Contrast)
Ultrasonography
Computed Tomography
Magnetic Resonance Imaging
Fluoroscopy
Cystoscopy
Nuclear Scintigraphy
Kidney. Surgical Techniques. Nephroureterectomy
Partial Nephrectomy
Postoperative Care
Functional Outcome and Potential Complications
Histologic Tumor Types and Prognosis
Adjuvant Therapy
Ureters
Surgical Techniques. Ureteric Resection and Anastomosis
Postoperative Care
Functional Outcome and Potential Complications
Histologic Tumor Types and Prognosis for Ureteral Tumors
Adjuvant therapy
Palliative Therapy
Bladder. Surgical Techniques. Partial Cystectomy
Total Cystectomy
Postoperative Care
Functional Outcome and Potential Complications
Histologic Tumor Types and Prognosis
Adjuvant and Alternative Therapies
Urethra
Surgical techniques. Urethral Resection with Vagino‐urethroplasty
Postoperative Care
Functional Outcome and Potential Complications
Histologic Tumor Types and Prognosis
Adjuvant and Alternative Therapies
Palliative Procedures. Tube Cystostomy
Urethral Stenting
Transurethral Resection
US‐guided Endoscopic Diode Laser Ablation
Radiation
References
12 Eyelids, Eye, and Orbit
Introduction
Clinical Workup and Biopsy Principles
Imaging Techniques
Eyelid Neoplasia. Surgical Techniques
Surgical Resection
V‐plasty and Four‐sided Excision
Advancement Flap
Rotational Flap
Semicircular Flap
Mucocutaneous Subdermal Plexus Flaps (Lip‐to‐lid)
Bucket Handle or Bridge Flap
Axial Pattern Flap Based on Cutaneous Branch of the Superficial Temporal Artery
Postoperative Care
Cryosurgery
Postoperative Care
Histologic Tumor Types
Presenting Signs and Differential Diagnosis
Prognosis
Other Therapies
Conjunctival, Nictitans, and Scleral Neoplasia. Surgical Techniques
Histologic Types
Presenting Signs and Differential Diagnosis
Prognosis
Eye Neoplasia. Surgical Techniques. Enucleation
Subconjunctival Enucleation
Transpalpebral Enucleation
Exenteration
Postoperative Care
Histologic Tumor Types and Prognosis. Primary Anterior Uveal Neoplasia
Secondary Anterior Uveal Neoplasia
Orbital Neoplasia. Surgical Techniques. Orbitotomy
Orbitectomy
Total Orbitectomy with Removal of the Eye
Dorsal Orbitectomy
Ventral Orbitectomy
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Presenting Signs, Histologic Tumor Types, and Prognosis
References
13 Endocrine System
Pituitary Tumors. Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques
Transphenoidal Hypophysectomy Using a CT Study
Transsphenoidal Hypophysectomy Using a High Definition Video Telescope (Mamelak et al. 2014)
Transsphenoidal Hypophysectomy Using a Sinus Venography Study
Intracranial Transtemporal Approach
Ventral Paramedian Approach and Use of a Cavitron Ultrasonic Aspirator
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Histologic Tumor Types
Adjuvant and Other Therapies
Hypophysectomy in Cats
Adrenal Tumors. Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques. Preoperative Management
Ventral Midline Approach
Flank and Intercostal Approach
Laparoscopy Technique (Pelaez et al. 2008; Mayhew et al. 2014; Pitt et al. 2016)
Partial Adrenalectomy
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Histologic Tumor Types
Adjuvant and Other Therapies
Thyroid Tumors: Feline Hyperthyroidism. Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques. Preoperative Management
Surgical Techniques
Parathyroid Autotransplantation
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Histologic Tumor Types
Adjuvant or Other Therapies
Thyroid Glands: Canine Thyroid Tumors. Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques. Preoperative Management
Surgical Considerations
Surgical Techniques
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Histologic Tumor Types
Adjuvant or Other Therapies
Ectopic Thyroid Tumors
Surgical Technique Requiring Partial Hyoidectomy (Milovancev et al. 2014)
Parathyroid Tumors. Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques. Parathyroidectomy. Preoperative Management
Surgical Techniques
Intraoperative Detection of Abnormal Glands
Excision of External Parathyroid Glands
Excision of Internal Parathyroid Glands
Excision of Multiple Abnormal Glands
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Hypocalcemia
Treatment of Acute Hypocalcemia
Maintenance Therapy
Disease Recurrence
Cats
Histologic Tumor Types
Adjuvant or Other Therapies
Endocrine Pancreatic Tumors. Clinical Workup and Biopsy Principles
Imaging Techniques
Surgical Techniques. Preoperative Management
Surgical Technique
Postoperative Care
Cosmetic and Functional Outcome, Potential Complications
Histologic Tumor Types
Adjuvant Therapy
References
14 Hemolymphatic System
Lymph Nodes
Surgical Anatomy
Lymph Node Imaging: Background
Imaging Techniques and Surgical Procedures
Regional Lymphoscintigram
Indirect CT Lymphography
Vital Dye Mapping
Intraoperative Lymphoscintigraphy
Lymphadenectomy
Axillary Lymph Node
Superficial Cervical Lymph Node
Inguinal Lymph Node
Popliteal Lymph Node
Complications of Lymphadenectomy
Common Tumors. Lymphangioma
Lymphangiosarcoma
Spleen. Surgical Anatomy
Imaging Techniques
Biopsy Technique
Preoperative Management
Surgical Procedures. Total Splenectomy
Partial Splenectomy or Surgical Splenic Biopsy
Postoperative Care
Potential Complications Associated with Splenectomy
Histologic Types
Prognosis and Adjuvant Therapy
Feline Splenic Disease
Thymus
Biopsy Technique
Imaging
Presenting Clinical Signs
Paraneoplastic Syndromes
Surgical Technique
Postoperative Care
Potential Complications
Adjuvant Treatments
Classification of Thymic Epithelial Tumors
Prognosis
Tonsils
Clinical Signs
Imaging and Staging
Biopsy
Tonsillectomy
Histologic Tumor Types
Prognosis
References
15 Nervous System
Introduction
Clinical Workup
Preoperative Imaging Techniques
Intracranial and Calvarial Tumors. Biopsy Principles – Brain
Biopsy Principles – Calvaria
Pre‐Operative and Perioperative Surgical Considerations
Surgical Planning and Patient Positioning
Intraoperative Considerations
Principles of Hemostasis
Surgical Approaches. Transfrontal Approach
Rostral Tentorial Approach
Bilateral Rostral Tentorial Approach
Caudal Tentorial Approach
Suboccipital Approach
Ventrocaudal Brain Stem Approach
Transsphenoidal Approach
Minimally Invasive Approaches
Modified Rostral Tentorial or Transtentorial Approach for Trigeminal Nerve Masses
Modifications to Surgical Approaches for Skull Masses
Intraoperative Navigation and Imaging Techniques
Species Differences
Post‐Operative Management
Cosmetic and Functional Outcomes
Potential Complications
Histologic Tumor Types of the Brain and Calvaria
Adjuvant Therapy and Prognosis
Ventricular Shunt Placement for Secondary Obstructive Hydrocephalus
Vertebral and Spinal Cord Tumors
Cerebrospinal Fluid Analysis
Biopsy Principles – Spine
Pre‐Operative and Perioperative Surgical Considerations
Intraoperative Considerations
Surgical Approaches
Hemilaminectomy (Thoracolumbar)
Hemilaminectomy (Cervical) – Modified Lateral Approach
Dorsal Laminectomy (Lumbosacral)
Dorsal Laminectomy (Cervical or Cranial Thoracic)
Lateral Approach to the Lumbosacral Foramina
Corpectomy (Partial)
Durotomy/Durectomy
Myelotomy
Vertebrectomy (Spondylectomy)
Stabilization
Post‐Operative Management
Cosmetic and Functional Outcomes
Potential Complications
Histologic Tumor Types of the Spinal Cord and Vertebrae
Adjuvant or Alternative Therapies and Prognosis
Nerve Sheath Tumors
Clinical Signs
Diagnostic Evaluation
Biopsy Techniques
Surgical Decision‐making
General Surgical Considerations
Surgical Approaches
Craniolateral Approach to Brachial Plexus
Craniomedial Approach to Brachial Plexus
Surgical Technique for Intraspinal Components
Durotomy and Rhizotomy
Species Differences
Post‐Operative Management and Potential Complications
Cosmetic and Functional Outcomes
Histologic Tumor Types of the Peripheral Nervous System
Adjuvant Therapies
Prognosis
References
16 Musculoskeletal Tumors
Osteosarcoma
Incidence and Risk Factors
Pathology and Natural Behavior
History and Clinical Signs
Prognostic Factors. Appendicular Osteosarcoma
Non‐Appendicular Osteosarcoma
Other Musculoskeletal Tumors
Chondrosarcoma
Hemangiosarcoma
Fibrosarcoma
Multilobular Osteochondrosarcoma
Metastatic Tumors of Bone
Benign Tumors of Bone. Osteomas
Multiple Cartilaginous Exostosis
Bone Cysts
Primary BoneTumors of Cats. Osteosarcoma
Fibrosarcoma, Chondrosarcoma, and Hemangiosarcoma
Multiple Cartilaginous Exostosis
Diagnostic Workup. Biopsy Techniques
Tissue Processing and Pathologic Interpretation
Imaging
Radiography
Computed Tomography
Magnetic Resonance Imaging
Nuclear Scintigraphy
Ultrasound
Positron Emission Tomography and Single Photon Emission Computed Tomography
Surgical Principles. Surgical Margins
Limb Amputation. Applicable Tumors
Patient Selection
Forequarter Amputation
Pelvic Limb Amputation (Coxofemoral Disarticulation)
Functional Outcome
Potential Complications
Hemipelvectomy. Applicable Tumors
Patient Selection
Preoperative Margin Assessment
Surgical Options
Total External Hemipelvectomy
Caudal External Hemipelvectomy
Cranial External Hemipelvectomy
Cranial Internal Hemipelvectomy
Caudal Internal Hemipelvectomy
Middle Internal or External Hemipelvectomy
Surgical Preparation
Surgical Technique
Medial Dissection
Lateral Dissection
Limb Amputation
Closure
Surgical Variations
Postoperative Complications
Functional Outcome
Cosmetic Outcome
Prognosis
Scapulectomy. Applicable Tumors and Patient Selection
Preoperative Margin Assessment
Surgical Technique
Cosmetic and Functional Outcome
Prognosis
Ulnectomy. Applicable Tumors and Patient Selection
Preoperative Margin Assessment
Surgical Technique
Cosmetic and Functional Outcome
Prognosis
Limb‐sparing Surgery. Applicable Tumors and Patient Selection
Preoperative Margin Assessment
Surgical Technique. Tumor Resection
Cortical Allograft
Endoprosthesis
Cosmetic and Functional Outcome
Potential Complications
Alternative Limb‐Sparing Techniques
Radial Autografting
Ulnar Autografting
Lateral Manus Translation
Bone Transport Osteogenesis
Intraoperative Extracorporeal Radiation
Transcutaneous Amputation Prosthesis
Patient‐Specific Implants: Computer Design and 3D Printing
Microwave Ablation
Limb Shortening
Digit‐Metacarpus‐Metatarsus Amputation. Patient Selection
Preoperative Margin Assessment
Surgical Technique
Cosmetic and Functional Outcome
Prognosis
Vertebral Tumors. Patient Selection
Surgical Technique
Prognosis
Joint Tumors. Patient Selection
Treatment
Prognosis
Muscle Tumors. Patient Selection
Intramuscular Hemangiosarcoma
Rhabdomyosacroma
Infiltrative Lipoma
Intermuscular Lipoma
Muscle Pseudotumors
Surgical Technique. Hemangiosarcoma, Rhabdomyosarcoma and Infiltrative Lipoma
Intermuscular Lipoma
Prognosis. Intramuscular Hemangiosarcoma
Rhabdomyosarcoma
Infiltrative Lipoma
Intermuscular Lipoma
Adjunctive Therapies. Applicable Tumors
Osteosarcoma and Chemotherapy
Osteosarcoma and Immunotherapy
Osteosarcoma and Radiation Therapy
Stereotactic Radiosurgery/Radiation Therapy (SRS or SRT)
Bisphosphonates
Osteosarcoma and Metastatectomy
Chondrosarcoma
Synovial Cell Sarcoma
Localized Histiocytic Sarcoma
References
17 Ethics and Surgical Limits of Surgical Oncology
Introduction
Surgical Limits
Anatomic Limits
Functional Limits
Ethical Limits
References
Index. a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
r
s
t
u
v
w
z
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