Intestinal incisional dehiscence rate following enterotomy for foreign body removal in 247 dogs

Abstract

OBJECTIVE To report the intestinal incisional dehiscence rate following enterotomy for foreign body removal in dogs. ANIMALS 247 client-owned dogs with intestinal foreign bodies treated with enterotomy between November 2001 and September 2017. PROCEDURES Medical records were reviewed, and data were collected regarding signalment, history, surgery, clinicopathologic findings, hospitalization, intestinal incisional dehiscence, and survival to hospital discharge. Dogs were grouped according to whether intestinal incisional dehiscence occurred (dehiscence group) or did not occur (nondehiscence group) following enterotomy, and the rate of dehiscence for the total number of enterotomies during the study period was calculated. Univariable analysis was performed to identify variables associated with intestinal incisional dehiscence. RESULTS 8 of the 247 (3.2%) dogs had preoperative septic peritonitis, and all 8 dogs survived to hospital discharge. Incisional dehiscence occurred following 5 of the 247 (2.0%) enterotomies, and only 2 dogs in the dehiscence group did not survive to hospital discharge. Duration of hospitalization was longer for dogs in the dehiscence group than for dogs in the nondehiscence group. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that enterotomy for intestinal foreign body removal had a lower rate of dehiscence in dogs during the study period, compared with rates previously reported; however, the low rate should not be used as a reason to perform an enterotomy rather than an enterectomy when needed. Surgeons should thoroughly evaluate the bowel and perform an enterotomy only when indicated.

Outcomes of dogs undergoing immediate or delayed surgical treatment for gastrointestinal foreign body obstruction: A retrospective study by the Society of Veterinary Soft Tissue Surgery

“…The comparison of dehiscence rates from previous studies is complicated by the many variables that exist within each study, such as case management, surgical technique, and proportion of enterectomies to enterotomies. Studies that involved enterectomies alone had much higher dehiscence rates (13%–14%) 7,29 compared with studies that involved enterotomies alone (2%–4%) 30,31 . Many of the historical studies that involved both enterotomies and enterectomies were published in the 1990's; our understanding of intestinal surgery and risk factors for dehiscence have improved over the past several decades and may be responsible for the overall improved outcomes seen in the study reported here.…”

“…Studies that involved enterectomies alone had much higher dehiscence rates (13%-14%) 7,29 compared with studies that involved enterotomies alone (2%-4%). 30,31 Many of the historical studies that involved both enterotomies and enterectomies were published in the 1990's; our understanding of intestinal surgery and risk factors for dehiscence have improved over the past several decades and may be responsible for the overall improved outcomes seen in the study reported here. In addition, this is the largest sample population of dogs undergoing gastrointestinal surgery from multiple institutions reported to date and, therefore, may be most representative of current dehiscence rates.…”

Perioperative Outcome in Dogs Undergoing Emergency Abdominal Surgery: A Retrospective Study on 82 Cases (2018-2020)

“…The 15-day mortality rate in this study was 20.7%. There is no comparable veterinary study with which to compare data, however, mortality rates reported in veterinary medicine for the most common surgical procedures encountered here, like gastrointestinal, hemoperitoneum or GDV syndrome surgeries, range from 0.8 to 28% [21][22][23][24][25][26], 12 to 36% [27,28] and 12 to 26 % [29][30][31][32][33][34][35][36], respectively.…”

Ex vivo comparison of leak testing of canine jejunal enterotomies: Saline infusion versus air insufflation

“…Using a table of random numbers, 10 segments from each cadaver were randomly allocated to two treatment groups: saline infusion enterotomy (n = 5) and air insufflation enterotomy (5). The remaining two segments were randomly allocated to two control groups: saline infusion control (n = 1) and air insufflation control (1). Thus, in total, each treatment group contained twenty-five 8-cm segments, and each control group contained five 8-cm segments.…”

“…Enterotomy and enterectomy closure integrity is frequently tested during intestinal surgery in human and veterinary surgery. Such evaluation aims at preventing postoperative dehiscence, reported in 2%-14.3% of small intestinal enterotomies, [1][2][3] 0%-28% of small intestinal anastomoses, [2][3][4][5][6][7][8][9][10][11][12][13][14] and 10%-32% of large intestinal fullthickness incisions 2,4,15 in dogs. Specifically, adoption of leak testing has been advocated as a means to identify poor surgical technique as a factor of dehiscence as it fails to consider other preoperative, intraoperative, intestine-dependent, and patient-dependent factors associated with dehiscence.…”