Long‐term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis

Suematsu, Masahiro; Suematsu, Hiroaki; Minamoto, Tomomi; Motomura, Noboru; Hirao, Daiki; Fujiki, Makoto

doi:10.1111/vsu.13229

Cited by 4 publications

(8 citation statements)

References 19 publications

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“…A recent study describes controlling hemostasis as the key to better visualization by the surgeon and reduction of the risk of iatrogenic nerve damage, especially the nerves in the area of the thorax entrance. The use of mediastinoscopy allows maintaining the endoscopic view of the mediastinal structures adjacent to the thoracic trachea, thereby minimizing injuries to the adjacent structures [12].…”

Section: Discussionmentioning

confidence: 99%

“…Two CCs had RLN involvement (28.57%). This complication, although undesired, occurs due to the proximity of the RLN to the trachea [3,12], and the risk of nerve injury can occur without the involvement of the prosthesis [2]. Thus, it is a complication that must be considered, which imposes the need for careful dissection.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, we believe that a complete postoperative evaluation can direct patients with this change in the immediate postoperative period, with arytenoid lateralization being performed only in patients with indication [3]. In a study in which 54 dogs received an extraluminal tracheal prosthesis, only 2% had unilateral laryngeal paralysis in the postoperative period, and this was corrected in a second surgical procedure using the arytenoid technique, with lateralization and consequent clinical improvement of the patient [12].…”

Section: Discussionmentioning

confidence: 99%

“…Tracheal collapse (TC) is a chronic progressive respiratory disease characterized by dorsoventral flattening of the trachea due to the weakening of the cartilaginous rings and widening of the tracheal muscle, which can occur in the cervical, thoracic and cervicothoracic portion. It is a common disease in adult dogs, especially small breed dogs [12,13]. Clinical signs of TC include respiratory problems, such as dry and severe cough ("goose honk" cough), raspy breathing, and occasionally dyspneic episodes and cyanosis [13] which can lead to death from airway obstruction in severe and progressive cases [12].…”

Section: Introductionmentioning

confidence: 99%

“…It is a common disease in adult dogs, especially small breed dogs [12,13]. Clinical signs of TC include respiratory problems, such as dry and severe cough ("goose honk" cough), raspy breathing, and occasionally dyspneic episodes and cyanosis [13] which can lead to death from airway obstruction in severe and progressive cases [12].…”

Section: Introductionmentioning

confidence: 99%

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New Technique for Intrathoracic Implantation of Extraluminal Spiral Prostheses in the Trachea

Gomes

Denevitz

Morales

et al. 2021

Acta Scientiae. Vet.

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Background: Extraluminal surgical procedures for intrathoracic tracheal collapse in dogs are not routinely performed. The patients are normally treated with different drugs or by intraluminal stents. However, in more severe cases, drug treatment does not always have good outcomes, and intraluminal prostheses can be correlated to several postoperative problems. In order to obtain better results, we aimed to develop a surgical technique for implantation of a new extraluminal helical prosthesis in the thoracic segment of the trachea through cervical access, associated with pneumatic mediastinoscopy for certification of the technique and minimization of possible complications.Materials, Methods & Results: Seven canine corpses (CCs) from non-traumatic death, weighing between 2 and 7 kg, were used. A ventral cervical approach to the trachea was associated with blunt mediastinal dissection. Trans cervical pneumatic mediastinoscopy was used for evaluation of the dissection and location of the implant. These were compared with the necropsy findings by the exact Wilcoxon two-sample test, with P < 0.05. The results of necropsy and mediastinoscopy did not present significant differences at P < 0.05. During the examinations, the presence of some mediastinal visceral lesions caused by the prosthesis, the integrity of the mediastinum and possible lesions to RLN and blood vessels (BV) were analyzed. We also investigated the location of the distal part of the prosthesis in the thoracic segment of the trachea and its dissection. To evaluate the technique, statistical comparison was made between mediastinoscopy and necropsy findings. The data were compared by the Wilcoxon test at 5% probability. The tracheas of all CCs were efficiently dissected, but in some cases problems that can happen during the procedure were noticed. This was checked by mediastinoscopy and confirmed by necropsy. The median of the scores was 1 (good dissection and visualization), with variance of zero for mediastinoscopy and 0.14 for necropsy. In the mediastinoscopy of one CC, the prosthesis crossed the tracheal bifurcation, involving the posterior vessels of this region, which was confirmed by necropsy. However, the dissection showed no vascular lesions. The integrity of the mediastinum was assessed only by mediastinoscopy. There was no impairment caused by any of the procedures performed. This resulted in a median score of 1 (integrity) with zero variance. When the positioning of the prosthesis was evaluated in relation to the tracheal bifurcation, identical values were obtained by both methods. The median score was 1, with variance of 0.62. No statistical differences were found between the two evaluation methods for the analyzed variables. This demonstrates the strong potential of the proposed evaluation techniques.Discussion: Our results show that the execution of the technique is possible, but some complications may occur. Mediastinoscopy as an evaluation procedure can pose some complications, these considerations are important, but by using technique proposed in this study, these factors are minimized due to the ease of technical implantation of the extraluminal tracheal stent, without the need for several instruments competing in the inflated mediastinal space. We concluded that the technique is viable and a safe method with minimal invasion for investigation and treatment of mediastinal diseases, presenting low impairment of the paratracheal structures, and that mediastinoscopy can be used as a transoperative evaluation method to minimize complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

New Technique for Intrathoracic Implantation of Extraluminal Spiral Prostheses in the Trachea

Gomes

Denevitz

Morales

et al. 2021

Acta Scientiae. Vet.

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Tracheal Surgery

MacPhail¹

2023

Small Animal Soft Tissue Surgery

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A systematic review and meta‐analysis of prevalence of complications after tracheal stenting in dogs

Robin,

Le Boedec

2024

Veterinary Internal Medicne

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BackgroundStenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome.ObjectivesDetermine the overall prevalence of complications of tracheal stenting in dogs.MethodsA bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta‐analyses were used to estimate pooled complications prevalence.ResultsFifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%–100%, late: 75%; 95% CI: 63%–85%, and clinically relevant: 52%; 95% CI: 42%–61%), tracheobronchial infections (24%; 95% CI: 14%–35%), and granulomas (20%; 95% CI: 11%–30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%–20%), relapsing collapse (10%; 95% CI: 5%–15%), and stent migration (5%; 95% CI: 1%–9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough.Conclusions and Clinical ImportanceTracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog's quality of life, owners must be informed that tracheal stenting is a second‐line procedure that does not necessarily alleviate the need for medical treatment and frequent follow‐up visits. Additional studies are warranted to identify the risk factors of these complications.

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Long‐term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis

Cited by 4 publications

References 19 publications

New Technique for Intrathoracic Implantation of Extraluminal Spiral Prostheses in the Trachea

New Technique for Intrathoracic Implantation of Extraluminal Spiral Prostheses in the Trachea

Tracheal Surgery

A systematic review and meta‐analysis of prevalence of complications after tracheal stenting in dogs

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