STS Journals - GI Oral-Rectum Flashcards by Oliver Taylor

Kilduff Taylor JSAP 2023 - Endoscopic treatment of acute oropharyngeal stick injuries in dogs: 46 cases (2010-2020)

What was the long-term complication rate?

What was the most common long-term complication?

2/40 - 5%
95% did well

Cervical abscessation

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Boot JSAP 2024 - Clinical manifestations, endoscopic findings and outcomes of tonsillar fossa foreign bodies in dogs: seven cases (2020-2023)

What was the most common clinical sign associated with tonsillar fossa FB?

Acute onset of throat clearing (100%
Palatine tonsil enlargement and protrusion from fossa (57%)

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Carroll JAVMA 2020 - Tumour size as a predictor of lymphatic invasion in oral melanomas of dogs

What was the outcome of this parameter with respect to lymphatic invasion?

Lymphatic invasion ruled out for tumours <6.5mm diameter
Ruled in for tumours >24.5mm diameter.

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Sharma VS 2021 - Survival time of juvenile dogs with oral squamous cell carcinoma treated with surgery alone: A Veterinary Society of Surgical Oncology retrospective study

What was the outcome of the dogs?

24/25 had complete margins

No dogs have evidence of recurrence or mets at long term follow up

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Bobis-Villagra JFMS 2022 - Feline sialocoele: clinical presentation, treatment and outcome in 19 cases

What type of sialocoele was most common?

What treatment was most commonly performed (if any)?

What was the rate of complications (what was it)?

What was the rate of recurrence?

Mandibular-sublingual complex

Sialoadenectomy

1/19 (5%), seroma

No recurrence observed

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Laureano JFMS 2024 - Feline minor salivary gland adenocarcinoma: retrospective case series and literature review

Where was the minor salivary gland adenocarcinoma most frequently observed?

What was recommended treatment?

MST?

Caudal labial masses

Aggressive excision with wide margins

787d (only 4 cats in study)

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Cinti VS 2021 - Complications between ventral and lateral approach for mandibular and sublingual sialoadenectomy in dogs with sialocele

What approach was associated with a higher risk of overall post-operative complications?

How did the recurrence rate differ between the techniques and what else was associated with an increased rate of recurrence?

No difference in overall complication rate
Wound-related complications more likely with ventral approach

Ventral approach associated with a lower risk of recurrence, surgical time

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Swieton JAVMA 2022 - Multi-institutional study of long-term outcomes of a ventral versus lateral approach for mandibular and sublingual sialoadenectomy in dogs with a unilateral sialocele: 46 cases (1999–2019)

What was the difference between lateral ventral approach for complications and recurrence?

What other factors were associated with the development of post-op complications?

No difference

Age and the presence of a pharyngeal sialocoele

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Gordo JSAP 2020 - The use of methylene blue to assist with parotid sialadenectomy in dogs

Name the two structures in close proximity to the parotid salivary gland shown in the attached photo. (right is rostral, up is dorsal)

Facial nerve and external carotid
Methylene blue stains parotid blue clearly demarcating it from these structures

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Ortilles JAVMA 2020 - Intracanalicular injection of N-acetylcysteine as adjunctive treatment for sialoceles in dogs: 25 cases (2000–2017)

How was this procedure performed?

What was the rate of recurrence?

Major papilla of the affected salivary gland was identified in the oral mucosa. A single intracanalicular injection of commercially available injectable 10% NAC solution was applied directly by retrograde infusion through the papilla of the affected gland

20%

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Viitanen VS 2023 - Intraoral approach for zygomatic sialoadenectomy in dogs: An anatomical study and three clinical cases

How did the intra-oral approach differ from traditional trans-zygomatic approach?

Which neurovascular structures are in close proximity to the zygomatic salivary gland?

Faster removal (42 mins) vs 65 mins. Ease of removal similar

Infraorbital artery
Auriculotemporal nerve (CN 5 V3)
Deep facial vein

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Dorner VS 2021 - Comparison of three surgical approaches for zygomatic sialoadenectomy in canine cadavers

What 3 approaches were compared?

Which approach did not allow complete gland extraction?

What was the author’s recommended approach? Why? And which neurovascular structure lies on the surface of the zygomatic salivary gland with this approach?

Zygomatic ostectomy approach
Dorsal non-ostectomy approach
Ventral non-ostectomy approach

Dorsal non-ostectomy approach

Ventral non-ostectomy approach - less tissue trauma (c.f. Zygomatic ostectomy) and more complete zygomatic gland extraction (c.f. dorsal approach)
Deep facial vein

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Bush VS 2023 - Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study

What was the MST?

What % had local recurrence?

What % had metastatic disease? Where was the most common location of mets?

What factor was associated with a decreased disease free interval?

1886d (~5y)

42%

32%, lungs

Presence of LN mets @ sx

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Boston VS 2020 - Outcomes of eight cats with oral neoplasia treated with radical mandibulectomy

What was the most common diagnosis?

What % of cats achieved independent food intake post-op?

What was the recurrence rate?

Other than recurrence, what other major (life-ending) complication was observed?

MST?

SCC

6/8 (75%)

2/8 (25%)

Aspiration of food

712d

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Chambers VS 2021 - Staged mandibular lip flap for closure of a large palatal defect after maxillectomy in a dog

What vessel does the staged mandibular lip flap rely on?

Staged procedure - 1st procedure mandibular lip flap based on inferior labial artery
4wk later - 2nd procedure - flap pedicle transected

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Tohy VS 2019 - Bilateral caudal maxillectomy for resection of tumours crossing the palatal midline and use of the angularis oris axial pattern flap for primary closure or dehiscence repair in two dogs

What complication was observed in both dogs?

Incisional dehiscence and subsequent oronasal fistula formation occurred as a postoperative complication in both dogs

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Warshaw JAVMA 2023 - Piezosurgical bone-cutting technology reduces risk of maxillectomy and mandibulectomy complications in dogs

How does the Piezosurgical system work?

What % of cases had excessive surgical bleeding which required admin of blood products?

Utilises US micro-oscillations at a rate of 28-36 oscillations/s

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Cray JAVMA 2021 - Analysis of risk factors associated with complications following mandibulectomy and maxillectomy in dogs

4 most common ddx

What was the complication rate? (minor %)?

Name the most common peri-op and post-op complications

What increased the risk of >1 complication?

What increased the risk of incisional dehiscence or oral fistular formation?

Acanthomatous amelioblastoma, SCC, oral melanoma, fibrosarcoma

37% complication rate (62% of which were minor)

Peri-op - Dehiscence, oronasal fistula, haemorrhage, infection, mandibular drift/malocclusion
Post-op - mandibular drift/malocclusion, ranula, infection, tumour recurrence

Increased surgical time (36% increase/hr of surgery)

Pre-op radiation/chemo and Maxillectomy (c.f. mandibulectomy)

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Carroll JSAP 2023 - Random mucosal rotating flaps for rostral to mid maxillary defect reconstruction: 26 dogs (2000-2019)

Poste-operative complications are more likely when mucosal rotating flaps are used to close what type of maxillary defect?

Mid-maxillary defect

Random mucosal rotating (transposition or interpolation) flaps are versatile when used to close rostral maxillary defects in dogs.

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Lhuillery JAVMA 2021 - Surgical management of a cervical oesophageal diverticulum in an long-term outcome for a five-month-old cat

How as the cervical oesophageal diverticulum managed?

Linear GIA endostapler staple height 4.8mm (closed height 2mm)

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Dollo JSAP 2020 - Endoscopic retrieval of gastric and oesophageal foreign bodies in 52 cats

What % of endoscopic retrievals were successful?

What % had major complications? Name some of the more common

What increased the risk of major complications?

94%

15% - pleural effusion (n=2), aspiration pneumonia (n=2), unsuccessful removal of foreign material with endoscopy (n=3), oesophageal stricture formation (n=3) and cardio-pulmonary arrest (n=1)

Oesophageal FBs (c.f. gastric)

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Bascunan VS 2020 - Vascular ring anomalies in cats: 20 cases (2000-2018)

What was the most common clinical sign?

What was the most common VRA observed?

What was the survival to discharge %?

What was the most common long term complication?

Regurgitation (90%)

PRAA (85%) (w. aberrant L subclavian in 20%)

90%

Persistent regurgitation in 69% (9/13), megaoesophagus in 31% (4/13)

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Beer JAVMA 2022 - Complications associated with and outcome of surgical intervention for treatment of esophageal foreign bodies in dogs

Short term post-op complication rate? Major comp?

Medium to long term post-op complication rate?

Survival to discharge?

What factors were associated w decreased survival?

29% (16/56). Major comp 25% (14/56 - 9 of which died).

50%

75% survival to discharge

Pre-op oesophageal perforation, undergoing thoracotomy and placement of G-tube

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Hosgood JAVMA 2021 - Circumferential oesophageal hiatal rim reconstruction for treatment of persistent regurgitation in brachycephalic dogs: 29 cases (2016-2019)

Describe the hiatal rim reconstruction

What procedure did all dogs have concurrently?

Hiatal rim reconstruction involved suture apposition of left & right pars lumbalis dorsal & ventral to oesophagus.

BOAS surgery

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Nash VS 2024 - Esophageal pH-monitoring in nonbrachycephalic dogs; a reference What was the reference limits for distal and proximal GER/hour? What was the upper ref range for cumulative distal and proximal oesophageal acid exposure?

Distal 2.4 GER/hour Proximal 0.4 GER/hour Distal 2.3% Proximal 0%

Winston VS 2023 - Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia-like syndrome Describe modified Heller myotomy procedure Describe Dor fundoplication What was the outcome of these surgeries? Why was sildenafil provided prior to surgery?

m.Heller myotomy - incision through serosa and muscularis at the cardia of the stomach and distal aspect of the esophagus Dor fundiplication - myotomy incision was sutured to the fundus of the stomach Signs improved in half of the population Oral sildenafil is a selective phosphodiesterase type 5 inhibitor that increases the effects of endogenous NO, resulting in smooth muscle relaxation in select tissues.

Abrams VS 2019 - Perioperative complications and outcome after surgery for treatment of gastric carcinoma in dogs: A Veterinary Society of Surgical Oncology retrospective study of 40 cases (2004-2018) What % had major complications? What was the most common major complication? What was the MST? What was associated with survival?

8/40 (20%) Dehiscence and septic peritonitis 178d (6m) Adjuvant chemotherapy (toceranib and carboplatin m.common), having no intra-op complication

Bahlmann JFMS 2022 - Gastric diverticula in six cats: a case series (2011–2020) How did they present? How was it diagnosed? How was it treated? What breeds are over-represented?

All cats presented for a variety of gastrointestinal disorders, including chronic vomiting, weight loss and anorexia Negative-contrast radiography Surgical resection Maine coon

Barandun JAVMA 2021 - Billroth II procedure for the treatment of spontaneous gastrointestinal perforation in two cats What is a Billroth II? What was the outcome?

Partial duodenectomy, partial gastrectomy (pylorectomy) and gastrojejunostomy At long term follow up 9 and 13m both cats were doing well

Buote VS 2023 - Laparoscopic vertical sleeve gastrectomy in felines: A cadaveric feasibility study and experimental case series in two cats At what point in the stomach was stenosis observed in 2/9 cadavers? Where were the ports positioned?

Incisura angularis See pic

Duffy VS 2021 - Evaluation of staple line reinforcement after partial gastrectomy closure in an ex vivo canine model What 3 closure techniques were compared? What was the outcome?

Single stapled line (4.8mm staples) Stapled line with suture oversew 2 layer suture closure Both 2 layer closures were biomechanically similar Both 2 layer closures were biomechanically superior to single stapled line

Webb VS 2019 - Influence of length of incision and number of suture lines on the biomechanical properties of incisional gastropexy How did the length of the incision influence the biomechanics? How did the number of suture lines affect the gastropexy biomechanics?

4cm incision had higher load to failure than 2cm incision No effect of number of suture lines

Baron VS 2020 - Paramedian incisional complications after prophylactic laparoscopy-assisted gastropexy in 411 dogs What was the rate of incisional complications? What was the most common? How were the majority managed? What factor increased the risk of complications?

19%, seroma Conservatively 96% Use of a single incision port (c.f. multiple ports)

Velay JAVMA 2023 - Safe gastric wall closure in dogs using a single-layer full-thickness simple continuous suture pattern What 3 closure techniques were performed? What was the difference between the 3 techniques?

Double layer inverting, single layer simple continuous and double layer simple continuous No difference in survival rate No major complications observed

Lhuillery VS 2022 - Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization How did the survival rates differ between delayed and immediate surgery? What factor was associated with increased mortality?

No difference. Prolonged medical stabilisation up to 13.7hrs was performed Hyperlactaemia 24hr post-IVFT initiation was associated with INCREASED mortality

White JAVMA 2021 - Evaluation of a staged technique of immediate decompressive and delayed surgical treatment for gastric dilatation-volvulus in dogs What factors were associated with mortality rate?

Plasma lactate, change in serial lactate and gastric necrosis Plasma lactate and change in serial lactate was associated with gastric health

Mullen VS 2024 - Use of real-time near-infrared fluorescence to assess gastric viability in dogs with gastric dilatation volvulus: A case-control study What % of cases had resection margins altered? How did fluorescence differ between tissues?

3/20 - 15% Fluorescence intensity lower in GDV viable and nonviable dogs c.f. healthy controls Fluorescence less in non-viable tissue (c.f.viable)

Monnet VS 2021 - Laparoscopic correction of sliding hiatal hernia in eight dogs: Description of technique, complications, and short-term outcome Where was the port placed? And where were additional ports placed if required? What surgery was performed to manage sliding hiatal hernia? What was the conversion rate?

Single port placed 2cm caudal to last left rib Unidirectional nonabsorbable barbed suture used for closure of oesophageal hiatus and oseophagopexy Conversion in 4/8 (50%)

Singh JAVMA 2023 - Laparoscopic surgical treatment for sliding hiatal hernia is associated with an owner-perceived improvement in clinical outcome in dogs Where was the camera placed? What was the most common intraop complication? What was the conversion rate?

Camera placed sub-umbilicus. 1 or 2 instrument ports 2-3cm caudal to costal arch and 3-5cm lateral to midline Pneumothorax (leakage of air through suture needle holes) 55% Conversion 22%

Grimes JAVMA 2020 - Characteristics and long-term outcomes of dogs with gastroesophageal intussusception What signalment is most common affected? What is the most frequent clinical sign? What is the survival to discharge? What was the most long term complication? What factors was it associated with?

Male, GSDs most commonly affected Vomiting and regurgitation 88% Persistent regurgitation Dogs with acute (≤ 7 days) clinical signs or a previous diagnosis of megaesophagus were more likely to have persistent regurgitation

Dobberstein VS 2022 - Primary repair of nonsteroidal anti-inflammatory drug-associated full thickness gastrointestinal ulcers in 11 dogs What was the survival to discharge? What factors were associated with mortality?

73% There was NO association between ulcer size/location and mortality

Rahn VS 2023 - Postoperative injectable opioid use and incidence of surgical site complications after use of liposomal bupivacaine in canine gastrointestinal foreign body surgery LB was associated with...

Shorter hospitalisation Shorter ICU times Less Fentanyl Increased wound complications

Pawenski JFMS 2024 - Histopathologic diagnosis and patient characteristics in cats with small intestinal obstructions secondary to trichobezoars (hairball) What were the most common cytological characteristics of the samples taken near site of trichobezoar? What were the most common diagnoses for all cats? And for cats >10y?

Neutrophilic inflam/erosion Lymphoplasmocytic or mixed lymp/eosino inflammation For cats >10y - small cell lymphoma Authors recommend obtaining multiple biopsies orad and aborad to the obstruction rather than at obstruction site

Tidd VS 2019 - Outcomes in 40 cats with discrete intermediate- or large-cell gastrointestinal lymphoma masses treated with surgical mass resection (2005-2015) What was the survival to discharge? MST? What factors were associated with survival?

36/40 - 90% 185d Longer survival for large intestinal masses (c.f. SI/gastric) or for complete surgical resection

Hiebert JFMS 2022 - Intestinal dehiscence and mortality in cats undergoing gastrointestinal surgery What was the rate of dehiscence? What % died within 10d of surgery? What factors were associated with a greater odds of mortality?

<1% 18% Cats w. preop septic peritonitis Cats that developed hypothermia 25-72h post-op

Sanders VS 2024 - Gastrointestinal thickness, duration, and leak pressure of five intestinal anastomosis techniques in cats What are the 5 intestinal anastomosis tested? What was the difference in ILP or MIP between groups? Which of the five was the quickest to perform?

(1) hand-sewn anastomosis – simple interrupted (2) hand-sewn anastomosis – simple continuous (3) functional end-to-end stapled anastomosis (4) functional end-to-end stapled anastomosis with oversew (5) skin stapled anastomosis No difference Nonoversewn FEESA (2.4x faster than FEESA and SS group, 4.7x HSA)

Miller VS 2024 - Performance time and leak pressure of hand-sewn and skin staple intestinal anastamoses and enterotomies in cadaveric cats How did the use of hand-sewn and skin staple techniques affect the ILP? What other significant finding was made in the enterotomy group?

No difference for enterectomies Lower ILP for SS enterotomy (c.f. handsewn) Immediate leakage was observed from the centre of 7/20 (35%) skin staple enterotomies

Gollnick JFMS 2023 - Retrospective evaluation of surgical treatment of linear and discrete gastrointestinal foreign bodies in cats: 2009–2021 What pre-op factors was linear FB associated with? What intra-op factors was linear FB ass. with? What post-op factors was linear FB ass. with?

Higher - BCS, Albumin Higher ASA status, longer surgery length Total cost of visit, higher risk of SSI and to receive postop AB

Haider JFMS 2019 - Enteroplication in cats with intussusception: a retrospective study (2001-2016) What signalment was over-represented?

Maine Coon, Male/Male castrated

Williams VS 2023 - Clinical outcomes of the use of unidirectional barbed sutures in gastrointestinal surgery for dogs and cats: A retrospective study What complication was seen with the use of unidirectional barbed sutures for GI surgery?

Stricture in 11% No increase in leakage, dehiscence or septic peritonitis

Duffy VS 2022 - Influence of crotch suture augmentation on leakage pressure and leakage location during functional end-to-end stapled anastomoses in dogs Which construct had the greatest ILP and reduced leakage?

2 crotch sutures (1 each side laterally) or simple continuous crotch suture

Quitzan VS 2022 - Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study Which staple line number and configuration had the highest ILP? Where did the initial leakage occur?

3 rows in transverse and vertical line (but no sig.diff between 3V3T and 2V3T) Transverse staple line

Chang VS 2021 - Influence of preconstructed effector loop location using a barbed unidirectional suture on leakage pressures following canine enterotomy closure Which reconstructed effector loop location was associated with a lower ILP? How much lower was it? Which reconstructed effector loop location was associated with a lower MLP?

When effector loop was anchored at 0mm from incisional line 40% No difference in MLP

Mullen VS 2021 - Ex vivo comparison of leak testing of canine jejunal enterotomies: Saline infusion versus air insufflation How did the use of saline infusion compare to air insufflation? Which was more likely to identify the location of leakage?

Enterotomy closures leaked at lower pressures when injected with air compared to saline. The location of leakage—most commonly suture tracks—was identified for all air constructs and for 14 of 25 saline constructs.

Chu VS 2020 - Ex vivo comparison of leakage pressures and leakage location with a novel technique for creation of functional side-to-side canine small intestinal anastomoses What were the 4 techniques compared? Which technique had the greatest LIP? What technique had the greatest MLP? Where was the most common initial leak location?

EBVS EBVS + transverse stapling All stapled EBVS + suture augmentation EBVS + suture augmentation All stapled With the EBVS group - side-to-side intestinal anastomosis fusion line

Duffy VS 2022 - Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model How did FEESA with barbed suture compare to monofilament suture oversew? Where was the Initial leak location for the majority of constructs?

Similar ILP and MLP Barbed suture quicker Crotch

Duffy VS 2020 - Influence of oversewing the transverse staple line during functional end-to-end stapled intestinal anastomoses in dogs What was the influence of oversewing the transverse staple line? What oversew pattern had the greatest ILP? Where was the ILL in the non-oversewn constructs?

Oversewing the transverse staple line increased maximal leakage pressure and decreased occurrence of leakage. Using Cushing pattern increased ILP vs simple continuous sutures. @ the level of the transverse staple line

Fealey VS 2020 - Initial leak pressures of four anastomosis techniques in cooled cadaveric canine jejunum Which of the following anastomosis techniques had the greatest ILP? - Handsewn - Handsewn w. barbed suture - Stapled - Stapled and oversewn - No difference observed

- No difference observed

Mullen VS 2020 - Gastrointestinal thickness, duration and leak pressure of six intestinal anastomoses in dogs How did the ILP/MLP for the anastomosis compare? What was the average thickness of the GI wall?

No difference in ILP/MLP between anastomosis All anastomosis techniques exceeded max.intraluminal peristaltic pressures Stomach 3.99mm, duodenum 2.34mm, jejunum 2.49mm, and ileum 2.30mm Authors suggest that we should be using green staples (2.0mm closed height)

Brand VS 2019 - Effects of needle gauge and syringe size on small intestinal leakage at injection sites How do the authors suggest performing the SI leak test to reduce chance of leakage through injection site?

10cm segment of SI, 25ga needle with 10 or 12ml syringe

Putterman VS 2019 - Successful vascularized jejunal patch graft to treat severe orad duodenal injury secondary to foreign body obstruction in a dog Describe the procedure briefly Outcome of surgery

Jejunal segment excised (maintaining mesenteric blood supply). Antimesenteric edge incised to make graft and sutured onto defect in duodenum No major complications, appetite and bowel movements normal within 2 weeks

Sumner VS 2019 - Evaluation of suture reinforcement for stapled intestinal anastomoses: 77 dogs (2008-2018) What was observed? Where was the location of dehiscence observed?

Lower post-op dehiscence in dogs with oversewn FEESA (0%) (c.f. non-oversewn (14%)) Transverse staple line in 100%

Simpson JSAP 2021 - Transversus abdominis muscle as a gastric or intestinal on-lay flap in two dogs and one cat Briefly describe the procedure

TA incised leaving dorsally based pedicle. Sutured to surface of intestine/stomach

Mullen JAVMA 2021 - Evaluation of intraoperative leak testing of small intestinal anastomoses performed by hand-sewn and stapled techniques in dogs: 131 cases (2008–2019) What was the reported dehiscence rate? How did it differ between those that had intra-op leak testing or not?

9% No difference

Thompson VS 2024 - Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies Which construct had the greatest ILP?

Handsewn and glue

Maxwell VS 2021 - 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 How did the surgeries differ when delayed? How did the outcomes differ when delated? What risk factors were identified for necrosis and perforations?

Increased enterectomies, duration of surgery and duration of anaesthesia w. delayed surgery No difference in outcome Duration of clinical signs, increased lactate, linear FB and sx timing Conclusion of study - Earlier surgical treatment of stabilized dogs with GIFBO may involve fewer complex procedures and accelerate recovery

Lopez JAVMA 2021 - Comparison of patient outcomes following enterotomy versus intestinal resection and anastomosis for treatment of intestinal foreign bodies in dogs What was the dehiscence rate of enterotomy and R+A? What factors were associated with increased risk of dehiscence?

Enterotomy 4% R+A 18% (6x risk) ASA>3 Older age

Demars JSAP 2023 - Surgical removal of intestinal foreign bodies using a laparotomy-assisted endoscopic approach in dogs and cats and comparison with enterotomy What was one of the risks described by authors?

Manipulating SI could result in serosal tears - which then required conversion to open

Treggiari JSAP 2023 - Canine gastrointestinal stromal tumours treated with surgery and imatinib mesylate: three cases (2018-2020) What is the IHC marker used for GIST tumours? What type of drug is Imatinib mesylate? How was it used in this case series?

c-KIT (CD 117) Tyrosine kinase inhibitor (similar to toceranib and mastinib) Adjuvant therapy for recurrent, metastatic or residual disease

Larose VS 2020 - Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions Which part of the GI tract was most common affected? What % had no identifiable cause? What % had recurrence? Post-op complications in what %? Severe complications in what %? Name some of the more common complications

Ileocolic 67% (2/3) 3% (4/153) 35% had complications, 14% severe Diarrhoea, regurg, septic peritonitis 6% mortality

Gill JAVMA 2019 - Factors associated with dehiscence and mortality rates following gastrointestinal surgery in dogs What factors were associated with an increased risk of dehiscence? What factors were associated with a lower likelihood of survival?

ASA > 3 ASA > 3 and high lactate

Strelchik JAVMA 2019 - Intestinal incisional dehiscence rate following enterotomy for foreign body removal in 247 dogs What was the reported enterotomy dehiscence rate?

2% (2/5 did not survive to discharge)

Mullen VS 2023 - A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health What was the outcome of this study?

Stapled enterectomies do not lead to greater vascular compromise than handsewn enterectomies.

Williams VS 2020 - Microorganisms associated with incisional infections after gastrointestinal surgery in dogs and cats What was the rate of incisional infections? What was the most commonly identified microorganism? What AB were all but two of these microorganisms resistant to?

7% E.coli Cefazolin (1st gen)/cefoxitin (2nd gen)

Sabetti JSAP 2023 - Endoscopic and surgical treatment of non-neoplastic proximal duodenal ulceration in dogs, and anatomical study of proximal duodenal vascularisation What was observed in the anatomical study? How did this explain the continuous bleeding observed in the clinical cases? How were the cases that were refractory to medical management treated?

Prominent venous plexus in the submucosa in the first half inch of the duodenum Ulcers appeared on the mesenteric side in this location Endoscopic electrocauterisation, surgical coagulation or resection of the proximal duodenal portion

Matz VS 2022 - Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers How did the TA stapler size affect the ILP?

No stat significance reached but... TA 30 V3 (2.5mm open, 1mm closed) staples had highest ILP

Sapora VS 2021 - Ex vivo comparison of hand-sutured versus circular stapled anastomosis in canine large intestine How did circular staplers compare with hand sutured anastomoses? Which size staple did NOT result in safe colonic anastomosis?

Circular stapled anastomosis leaked at lower pressures than hand-sutured anastomosis Use of a 3.5mm staple height (closed 1.5mm) - 2/6 leaked immediately

Grossman JAVMA 2022 - Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats What was the major complication rate? What was the mortality rate? What factors were associated with a shorter survival time? What was the constipation recurrence rate? What was removal of the ICJ associated with?

10% 14%, BCS<4/9, pre-exiting heart disease, major peri-op complications, post-op liquid faeces 32% (at median 344d) Long term liquid faeces, fair/poor owner assessed outcome NOT recurrence of constipation

Lux JAVMA 2021 - Evaluation of short-term risk factors associated with dehiscence and death following full-thickness incisions of the large intestine in cats: 84 cases (1993–2015) What was the rate of dehiscence? What was the survival to discharge?

8% 94% Paper also has lots of factors associated with dehiscence/survival etc

Latimer JAVMA 2019 - Evaluation of short-term outcomes and potential risk factors for death and intestinal dehiscence following full-thickness large intestinal incisions in dogs Dehiscence rate? Mortality rate?

10% 17%

McKenna JSAP 2021 - Diagnosis and treatment of a caecal mucocoele in a dog

Sutton JSAP 2022 - Computed tomographic staging of dogs with anal sac adenocarcinoma What was the rate of LN mets? Pulmonary mets? What was the main finding of this paper?

71% - LN mets, 11% - pulmonary mets No association between AGASACA size and presence of iliosacral LN enlargement

Schlag JSAP 2020 - Comparison of methods to determine primary tumour size in canine apocrine gland anal sac adenocarcinoma What factors were associated with an increased risk of mets?

Vascular invasion, tumours >2.5cm (as per palp, CT or histo) Tumours staged as 1 if <2.5cm or 2 if >2.5cm

Chen JAVMA 2021 - Minimal complications observed with a modified surgical approach for treatment of canine anal sac neoplasia Describe briefly the modification utilised

Incision over duct and sac. Monopolar cautery utilised for dissection from anal sphincter

Griffin JAVMA 2023 - Short- and long-term outcomes associated with anal sacculectomy in dogs with massive apocrine gland anal sac adenocarcinoma What was the rate of post-op comp? Local recurrence in what %? What was associated with increased risk of local and distant mets? MST?

36% - no permanent faecal incontinence, tenesmus or anal stenosis 37% Presence of l.node mets @ sx 671d (~2y) - not affected by presence of mets OR adjuvant therapy PFI 204d and associated with presence of l.node mets

Fontes JAVMA 2023 - Long-term outcomes associated with a modified versus traditional closed anal sacculectomy for treatment of canine anal sac neoplasia What are the reported benefits of a modified approach (over the closed technique)? How did the modified approach compare with traditional closed anal sacculectomy?

Ability to remove entire duct No benefit in complication rate or local recurrence

Franca JSAP 2024 - Histopathological diagnosis and surgical complications following bilateral anal sacculectomy for the treatment of unilateral canine apocrine gland anal sac adenocarcinoma: 35 cases (2019-2023) What % of contralateral anal sacs were histologically normal? What % of contralateral anal sacs had evidence of neoplasia? What were the most frequent intra-op and post-op complications associated with this procedure?

14% 5/35 20% neoplastic Intra-op (9%) - Tumour capsule disruption Post-op (14%) - SSI

Gotzens JAVMA 2020 - Dorsal displacement of the rectum after proximal tail amputation and subsequent surgical repair by bilateral semitendinosus muscle transposition in a cat What two muscles were transected in the tail amputation which resulted in dorsal deviation of the rectum?

Sacrocaudal and rectococcygeal muscles

Hubers JSAP 2022 - Outcome of surgical treatment of perineal hernia in cats: 36 cases (2013-2019) What was the most common signalment? Bilateral vs unilateral? What % had good outcome? What complications were seen in cases that had poor outcome?

Male neutered (median age 10y) Bilateral 34/36 74% Megacolon or recurrence of hernia/clinical signs

Sandoval JSAP 2022 - Outcomes and complications of anal sacculectomy for non-neoplastic anal sac disease in cats: 8 cases (2006–2019) What was the rate of minor complications? What was the rate of permanent faecal incontinence?

50% (4/8) 0%

Kopke JSAP 2021 - Squamous cell carcinoma of the anal sac in two cats What treatment options were utilised?

Surgical excision, radiation and toceranib (then carboplatin when it recurred) - 552d Palliative care w. meloxicam - 28d

Cinti VS 2019 - Temporary end-on colostomy as a treatment for anastomotic dehiscence after a transanal rectal pull-through procedure in a dog Which muscle is transected for the transanal rectal pull through procedure?

Rectococcygeal muscle

Tobias VS 2022 - Perineal hernia repair in dorsal recumbency in 23 dogs: Description of technique, complications, and outcome What factor decreased the risk of hernia recurrence? Name two significant post-op complications observed during this study

Dogs that had no prior hernia repair or organ pexy Incisional infection/drainage and persistent urinary incontinence

Cinti VS 2021 - A novel technique to incorporate the sacrotuberous ligament in perineal herniorrhaphy in 47 dogs What structures run in close proximity to the sacrotuberous ligament? How did Cinti ensure that the structures were not entrapped?

Sciatic nerve (caudal gluteal artery and vein) Passed suture round ST lig (w.out needle), pulled sutures tight and checked for reaction under GA prior to incorporating sutures into repair.

Bitton VS 2020 - Use of bilateral superficial gluteal muscle flaps for the repair of ventral perineal hernia in dogs: A cadaveric study and short case series Name the origin and insertion of the SGM Describe the procedure What was the outcome of this procedure?

Origin - lateral aspect of the sacrum, first tail vertebra and sacrotuberous ligament Insertion - 3rd trochanter Origin and insertions transected (other than muscle fibres on 1st tail vertebrae and ST lig. Sutured together ventral to anal sphincter No recurrence detected @ 6-12m

Rossello JSAP 2023 - Combined transposition of internal obturator and superficial gluteal muscles for perineal hernia treatment in dogs: 17 cases (2017-2020) Briefly describe the procedure What post-operative complication was observed? What was the recurrence rate?

T shaped incision. Superficial gluteal transposition (transection at insertion onto 3rd trochanter) used for dorsal aspect of defect. Internal obturator used for ventral aspect of defect. Minor dehiscence at the T shaped incision 0%

Cantatore VS 2022 - Submucosal resection via a transanal approach for treatment of epithelial rectal tumors – a multicenter study What was the complication rate? And the most common complication? Recurrence rate? What factors were associated with an increased recurrence rate? Recurrence was associated with? Carcinoma 1y, 2y and 5y survival?

29%, Dyschezia 21% - incomplete margins and complications Increased risk of death 1y - 95%, 2y - 89%, 5y - 73%

Mayhew VS 2020 - Evaluation of transanal minimally invasive surgery for submucosal rectal resection in cadaveric canine specimens What insufflation pressure was utilised?

8-10mmHg

Sabattini JSAP 2021 - Cytological differentiation between benign and malignant perianal gland proliferative lesions in dogs: a preliminary study What was the diagnostic accuracy? What cytological features were used?

87% Clusters w. total lack of distinction between hepatoid cells and reserve cells Presence of reserve cells or poorly differentiated cells Nuclear atypia N:C>1

STS Journals - GI Oral-Rectum Flashcards

(100 cards)