猫における開腹卵巣摘出術（縫合またはバイポーラ血管シーリングデバイスを使用）と腹腔鏡下アプローチの比較

To compare surgical time, incision length, intraoperative bleeding, and post-operative pain in cats undergoing three different ovariectomy techniques: open surgery with pedicle ligation using sutures, open surgery using a bipolar vessel-sealing device, and a two-port laparoscopic approach. A prospective randomized clinical trial was conducted on 27 healthy female cats assigned to three treatment groups (n = 9 per group). Surgical variables were recorded intraoperatively, and post-operative pain was assessed using a validated feline pain scale at hourly intervals over four hours. The laparoscopic group had the shortest incision length (mean 10.0 mm, SD 0.0) compared to the suture (mean 33.3 mm, SD 5.6) and bipolar device groups (mean 28.7 mm, SD 6.4). Surgical time was significantly shorter in the BVSD (27.0 ± 9.6 min) and LOVE groups (30.2 ± 5.2 min) compared with the Suture group (43.9 ± 14.4 min; one-way ANOVA, p = 0.005; Tukey post-hoc p < 0.05 vs. Suture for both comparisons). Post-operative pain scores at one hour (T1) were lower in the LOVE group (median 4 [IQR 3-5]) than in both open groups (Suture: 9 [IQR 8-9]; BVSD: 7 [IQR 6-8]; Kruskal-Wallis, p = 0.014; Dunn's post-hoc p < 0.05 vs. BVSD and trend towards lower scores vs. Suture). Only 1 of 9 cats requiring rescue analgesia versus 7 of 9 in each open group. The laparoscopic approach was associated with lower post-operative pain scores and a reduced need for rescue analgesia compared to open ovariectomy techniques, suggesting improved perioperative comfort. Although the laparoscopic group showed a significantly shorter surgical time compared with the suture group, this observation should be interpreted cautiously due to potential operator- and case-dependent variability. Nevertheless, laparoscopic ovariectomy in cats should be considered a promising and welfare-oriented technique that warrants further investigation.