Perioperative morbidity and outcome of esophageal surgery in dogs and cats: 72 cases (1993–2013)

Abstract

OBJECTIVE To evaluate perioperative morbidity and outcome in dogs and cats undergoing esophageal surgery. DESIGN Retrospective case series. ANIMALS 63 client-owned dogs and 9 client-owned cats. PROCEDURES Medical records of dogs and cats that underwent esophageal surgery were reviewed for information on signalment, history, results of preoperative diagnostic testing, condition treated, details of surgery, intraoperative complications, and postoperative complications. Long-term follow-up data were obtained via veterinarian and client telephone conversations. The relationship between complications and survival to hospital discharge was evaluated by means of regression analysis. RESULTS The most common indication for surgical intervention was an esophageal foreign body in dogs (50/63 [79%]) and esophageal stricture in cats (3/9). Complications were documented in 54% (34/63) of dogs and 3 of 9 cats. The most common immediate postoperative complications were respiratory in nature (9 dogs, 1 cat). Partial esophagectomy and resection with anastomosis were significantly associated with the development of immediate postoperative complications in dogs. The most common delayed postoperative complications were persistent regurgitation (7 dogs) and esophageal stricture formation (3 dogs, 1 cat). For dogs, a mass lesion and increasing lesion size were significantly associated with the development of delayed postoperative complications. Six dogs (10%) and 1 cat died or were euthanized prior to discharge, and pneumomediastinum and leukopenia were negative prognostic factors for dogs being discharged from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study suggested that the short-term prognosis for dogs and cats that survive surgery for treatment of esophageal lesions is favorable, with 90% of patients discharged from the hospital (57/63 dogs; 8/9 cats). However, dogs treated for more extensive esophageal lesions as well as those undergoing esophagectomy or resection and anastomosis were more likely to develop postoperative complications.

Risk Factors for Death in Dogs Treated for Esophageal Foreign Body Obstruction: A Retrospective Cohort Study of 222 Cases (1998–2017)

“…Fifty breeds of dogs were represented. West Highland White Terriers (n = 22) and Labradors (n = 22) were the most commonly represented breeds, followed by Staffordshire Bull Terriers (20), Maltese (17), Boxers (14), and Chihuahuas (n = 10).…”

“…In a study comparing endoscopic and surgical treatment, the case fatality rate for surgery was approximately twice that of endoscopic cases; however, there was no significant difference between groups . In a different study, the case fatality rate for dogs with EFB treated surgically was 7.9%; however, dogs that died or were euthanized intraoperatively were excluded from the study, likely underestimating surgical fatality rates . Another recent paper reported high success rates for surgical treatment of EFB .…”

Endoscopic retrieval of gastric and oesophageal foreign bodies in 52 cats

“…Canine oesophagotomy mortality rates range from 7% to 42.3% (Houlton et al 1985, Sale & Williams 2006, Burton et al 2017. Complication rates of 14.3% to 63.6% have been reported with oesophagotomy in dogs and complications include oesophageal wound dehiscence and leakage, pyothorax, mediastinitis, pleuritis, and post-operative stricture formation (Sale & Williams 2006, Deroy et al 2015, Sutton et al 2016.…”

“…, Sutton et al . ). Because minimising morbidity is a primary goal in relieving an obstruction, endoscopic retrieval of OFBs and GFBs is the preferred treatment method when possible (Bebchuk ).…”

“…Endoscopy helps avoid surgical procedures and operative pain, resulting in shorter recovery times, and allows an assessment of mucosal damage (Neiger et al 2013, Deroy et al 2015. Endoscopy is especially useful for the retrieval of foreign bodies in the oesophagus, a site with increased risk for surgical incision dehiscence due to its segmental blood supply, lack of omentum, and high incisional tension (Aronson et al 2000, Sutton et al 2016. Because minimising morbidity is a primary goal in relieving an obstruction, endoscopic retrieval of OFBs and GFBs is the preferred treatment method when possible (Bebchuk 2002).…”