An 11-year-old male Cocker Spaniel was examined for a palpable abdominal mass located in the jejunum after presenting with a history of anorexia and constipation for several weeks. In a contrast radiogram, a structure with well-defined borders adjacent to the intestine was determined. The intestinal mass, measuring 16 × 9.19 × 8.6 cm and weighing 900 g was surgically removed. At gross examination, when the lumen of a portion of the intestine excised together with the tumour mass was exposed, an ulcerated, oval-shaped area 1.2 × 0.6 cm in size was observed on the mucosa. The outer surface of the tumour was homogenous and expanded outwards from the intestinal wall. Histologically, the tumour was composed of fusiform-elongated spindle-shaped to polygonal neoplastic cells forming interlacing fascicles or interwoven bundles in an atypical herringbone pattern. Immnunohistochemically, neoplastic cells stained intensely positive for vimentin, and negative for α-SMA, desmin, cyotokeratin (AE1/AE3), S-100 protein, glial fibrillary acidic protein, neuron specific enolase and synap-tophsin. On the basis of the histopathological and immunohistochemical results, the tumour was diagnosed as a fibrosarcoma. The present report is a very rare description of fibrosarcoma of the dog intestine associated with intestinal perforation.
Objectives
Postoperative ventilatory strategies in patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) may have an impact on early postoperative complications. Our national Esophageal Atresia Registry was evaluated to define a possible relationship between the type and duration of respiratory support on postoperative complications and outcome.
Study Design
Among the data registered by 31 centers between 2015 and 2021, patients with esophago‐esophageal anastomosis (EEA)/tracheoesophageal fistula (TEF) were divided into two groups; invasive ventilatory support (IV) and noninvasive ventilatory support and/or oxygen support (NIV‐OS). The demographic findings, gestational age, type of atresia, associated anomalies, and genetic malformations were evaluated. We compared the type of repair, gap length, chest tube insertion, follow‐up times, tensioned anastomosis, postoperative complications, esophageal dilatations, respiratory problems requiring treatment after the operation, and mortality rates.
Results
Among 650 registered patients, 502 patients with EEA/TEF repair included the study. Four hundred and seventy of patients require IV and 32 of them had NIV‐OS treatment. The IV group had lower mean birth weights and higher incidence of respiratory problems when compared to NIV‐OS group. Also, NIV‐OS group had significantly higher incidence of associated anomalies than IV groups. The rates of postoperative complications and mortality were not different between the IV and NIV‐OS groups.
Conclusion
We demonstrated that patients who required invasive ventilation had a higher incidence of low birth weight and respiratory morbidity. We found no relation between mode of postoperative ventilation and surgical complications. Randomized controlled trials and clinical guidelines are needed to define the best type of ventilation strategy in children with EA/TEF.
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