Esophageal Surgery

Question 1

Pollard, VRU, 2017:
Contrast videofluoroscopic swallowing studies in dysphagic dogs

What % of dysphagic dogs had multiple abnormalities?

Answer 1

Pollard, VRU, 2017:

38% had multiple abnormalities

Question 2

Elvers, JVIM, 2019:
Videofluoroscopic swallowing studies in brachycephalic vs non-brachycephalic dogs

1. What % of dogs had hiatal hernias?
2. What % of dogs that had hiatal hernias were brachycephalic?
3. What was brachycephaly associated with?

Answer 2

Elvers, JVIM, 2019:

1. 22% had hiatal hernias
2. 100% of the dogs that had hiatal hernias were brachycephalic
3. Brachycephaly was associated with idiopathic esophageal dysmotility, prolonged esophageal transit time, gastroesophageal reflux and hiatal hernia

Question 3

Burton, JVIM, 2017:
Esophageal foreign bodies

1. Most common location for esophageal FB?
2. Overall mortality rate?
3. Mortality rates for surgical cases vs endoscopic cases?
4. What % developed esophageal strictures?
5. Risk factors for death?

Answer 3

Burton, JVIM, 2017:

1. Most common location for esophageal FB was distal esophagus
2. Overall mortality rate: 5%
3. Mortality rates: 23% for surgical cases vs 2% for endoscopic cases
4. 2% developed esophageal strictures
5. Risk factors for death: esophageal perforation, hemorrhage within the esophagus

Question 4

Sterman, JAVMA, 2018:
Esophageal perforation secondary to esophageal foreign body

1. What % of dogs had esophageal perforation?
2. What was associated with increased likelihood of esophageal perforation?
3. What % of esophageal perforations were diagnosed on routine thoracic radiographs?
4. What % of esophageal perforations did not require surgical intervention?

Answer 4

Sterman, JAVMA, 2018:

1. 12% had esophageal perforations
2. Delay in seeking veterinary attention increased the likelihood of esophageal perforation
3. 27% of esophageal perforations were diagnosed on routine thoracic radiographs
4. 60% of esophageal perforations did not require surgical intervention, suggesting rapid sealing of esophageal defects

Question 5

Teh, JVECC, 2018:
Medical management of esophageal perforations secondary to esophageal foreign body

What % survived to discharge?

Answer 5

Teh, JVECC, 2018:

80% survived to discharge

Question 6

Brisson, JAVMA, 2018:
Esophageal foreign bodies

1. Most common esophageal foreign body?
2. Most common location of esophageal foreign bodies?
3. Most common location of fish hook foreign bodies vs bone foreign bodies?
4. Factors associated with a poor outcome?
5. What % developed esophageal strictures?

Answer 6

Brisson, JAVMA, 2018:

1. Most common esophageal FB was bone (60% of cases)
2. Most common location of esophageal FBs was caudal esophagus (58% of cases), followed by the heart base (23% of cases)
3. Most common location for fish hook FBs was cervical esophagus, most common location for bone FBs was caudal esophagus
4. Factors associated with a poor outcome: longer duration of FB entrapment, esophageal perforation, older age
5. 11% developed esophageal strictures

Question 7

Bongard, JVECC, 2019:
Esophageal foreign bodies

1. Overall success rate for foreign body removal via esophagoscopy?
2. Complication rate?
3. Dogs with foreign bodies present for >24 hours were more likely to have what?
4. What type of foreign body was more likely to require surgical removal?

Answer 7

Bongard, JVECC, 2019:

1. Overall success rate for FB removal via esophagoscopy: 95%
2. Complication rate: 22%
3. Dogs with foreign bodies present for >24 hours were more likely to have severe esophagitis and major complications
4. Fish hooks were more likely to require surgical removal

Question 8

Lam, JVIM, 2013:
Esophageal stenting for refractory benign esophageal strictures

What % of dogs required intervention due to complications?

Answer 8

Lam, JVIM, 2013:

80% of dogs required intervention due to complications

Question 9

Grobman, JVIM, 2019:
Mechanical dilation, botulinum toxin A injection and surgical myotomy with fundoplication for lower esophageal sphincter achalasia-like syndrome

1. Duration of effect?
2. What persisted despite clinical improvement?

Answer 9

Grobman, JVIM, 2019:

1. Duration of effect: 40 days
2. Megaesophagus and abnormal esophageal motility persisted despite clinical improvement

Question 10

Breheny, JVIM, 2019:
Complications associated with esophageal feeding tubes

1. Complication rate?
2. What factors were associated with increased odds of developing a stoma site infection?

Answer 10

Breheny, JVIM, 2019:

1. Complication rate: 36%
2. Administration of glucocorticoids or oncolytic agents and discharge at the stoma site were associated with increased odds of developing a stoma site infection

Question 11

Nathanson, JVIM, 2019:
Complications associated with esophageal feeding tubes

1. Overall complication rate?
2. What % of cats vs dogs developed signs of infection at the tube site?
3. What % of cats vs dogs developed regurgitation of food through the tube stoma?

Answer 11

Nathanson, JVIM, 2019:

1. 44% complication rate
2. 18% of cats vs 14% of dogs developed signs of infection at the tube site
3. 1% of cats vs 7% of dogs developed regurgitation of food through the tube stoma

Question 12

Sutton, JAVMA, 2016:
Peri-op morbidity and outcome of esophageal surgery

1. Overall complication rate in dogs vs cats?
2. Intra-op complication rate in dogs vs cats?
3. Immediate post-op complication rate in dogs vs cats?
4. Delayed post-op complication rate in dogs vs cats?
5. In dogs, what factors were associated with immediate post-op complications?
6. In dogs, what factors were associated with delayed post-op complications?
7. Mortality rate in dogs vs cats?
8. Risk factors for death in dogs?

Answer 12

Sutton, JAVMA, 2016:

1. Overall complication rate: 54% in dogs vs 33% in cats
2. Intra-op complication rate: 13% in dogs vs 0% in cats
3. Immediate post-op complication rate: 37% in dogs vs 33% in cats
4. Delayed post-op complication rate: 21% in dogs vs 11% in cats
5. In dogs, partial esophagectomy and esophageal resection and anastomosis were associated with development of immediate post-op complications
6. In dogs, increasing lesion size and presence of a mass lesion were prognostic factors for the development of delayed post-op complications
7. Mortality rate: 10% in dogs vs 11% in cats
8. Risk factors for death in dogs were presence of pre-op pneumomediastinum and leukopenia