Kyles Andrew E, Feldman Edward C, De Cock Hilde E V, Kass Philip H, Mathews Kyle G, Hardie Elizabeth M, Nelson Richard W, Ilkiw Janet E, Gregory Clare R
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2003 Sep 1;223(5):654-62. doi: 10.2460/javma.2003.223.654.
To compare pathologic findings and results of adrenalectomy for adrenal gland tumors in dogs with and without vena caval tumor thrombi.
Retrospective study.
40 dogs with adrenal gland tumors.
Medical records were examined. An exact logistic regression analysis was used to evaluate associations between tumor type or right-sided versus left-sided tumor involvement and development of caval tumor thrombi and associations between tumor thrombi, tumor type, or right- versus left-sided location and perioperative complications and mortality rate. Survival was compared between dogs with and without tumor thrombi.
Caval thrombi were detected in 25% of dogs, including 3 of 28 (11%) dogs with an adrenocortical tumor and 6 of 11 dogs with a pheochromocytoma. A caval tumor thrombus was detected in 6 of 17 right-sided and 4 of 20 left-sided tumors. Sensitivity and specificity of abdominal ultrasonography for detection of caval thrombi were 80 and 90%, respectively. Intraoperative and postoperative complications developed in 15 and 51% of dogs, respectively. The mortality rate was 22%. There were no significant differences in perioperative morbidity and mortality rates between dogs with and without tumor thrombi.
Caval thrombi associated with adrenal gland tumors are amenable to adrenalectomy and thrombectomy without significantly increased perioperative morbidity and mortality rates, assuming the surgeon is experienced in appropriate techniques.
比较有或无腔静脉肿瘤血栓的犬肾上腺肿瘤的病理检查结果及肾上腺切除术的结果。
回顾性研究。
40只患有肾上腺肿瘤的犬。
检查病历。采用精确逻辑回归分析来评估肿瘤类型或右侧与左侧肿瘤累及情况与腔静脉肿瘤血栓形成之间的关联,以及肿瘤血栓、肿瘤类型或右侧与左侧位置与围手术期并发症及死亡率之间的关联。比较有和无肿瘤血栓的犬的生存率。
25%的犬检测到腔静脉血栓,包括28只肾上腺皮质肿瘤犬中的3只(11%)和11只嗜铬细胞瘤犬中的6只。17例右侧肿瘤中有6例、20例左侧肿瘤中有4例检测到腔静脉肿瘤血栓。腹部超声检测腔静脉血栓的敏感性和特异性分别为80%和90%。分别有15%和51%的犬发生术中及术后并发症。死亡率为22%。有和无肿瘤血栓的犬在围手术期发病率和死亡率方面无显著差异。
对于与肾上腺肿瘤相关的腔静脉血栓,若外科医生具备适当技术经验,肾上腺切除术和血栓切除术是可行的,且围手术期发病率和死亡率不会显著增加。