Preoperative Imaging in Predicting Post-Surgical Complications in Small Animals: Insights from In Vivo Studies
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Abstract
Preoperative imaging is a key tool in small-animal surgery; however, its predictive value for postoperative complications remains to be carefully investigated. The present study aimed to assess the predictive value and limitations of preoperative radiology for postoperative complications in small animals, based on evidence from in vivo studies. A systematic search of PubMed, Scopus, Web of Science, and Google Scholar databases was performed between 2020 and 2025 using keywords related to preoperative imaging, postoperative complications, dogs, cats, and animal models. Inclusion criteria included in vivo experimental studies on small animals (dogs and cats), reporting at least one preoperative imaging modality, including radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). Case reports, case series with a sample size of less than 5, and review articles were excluded. Out of 522 initial studies, duplicates were removed, and titles and abstracts were screened. This process resulted in 135 articles being fully evaluated, from which 116 studies were excluded, leaving 19 studies for inclusion. The positive predictive value of imaging for complications such as intestinal anastomotic leakage, pneumothorax after thoracotomy, and uroma after urinary tract surgery was moderate to acceptable. However, major limitations were present, including low sensitivity for detecting mild adhesions, inability to predict individual fibrotic responses, and failure to detect local microbiota. Additionally, normal preoperative radiological findings in small animals were associated with significant postoperative complications. Preoperative radiology in small animals has moderate to high predictive value for specific complications such as syringomyelia. However, owing to its limited sensitivity in detecting microscopic involvement and variations in individual tissue responses, preoperative radiology cannot serve as the only tool for clinical decision-making. Combining imaging with serum biomarkers and complementary laparoscopic evaluation are necessary for predicting post-surgical complications in small animals.
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