Snowdon Kyle A, Smeak Daniel D, Chiang Sharon
College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado.
Vet Surg. 2016 Jan;45(1):91-9. doi: 10.1111/vsu.12413. Epub 2015 Nov 13.
To identify risk factors for dehiscence in stapled functional end-to-end anastomoses (SFEEA) in dogs.
Retrospective case series.
Dogs (n = 53) requiring an enterectomy.
Medical records from a single institution for all dogs undergoing an enterectomy (2001-2012) were reviewed. Surgeries were included when gastrointestinal (GIA) and thoracoabdominal (TA) stapling equipment was used to create a functional end-to-end anastomosis between segments of small intestine or small and large intestine in dogs. Information regarding preoperative, surgical, and postoperative factors was recorded.
Anastomotic dehiscence was noted in 6 of 53 cases (11%), with a mortality rate of 83%. The only preoperative factor significantly associated with dehiscence was the presence of inflammatory bowel disease (IBD). Surgical factors significantly associated with dehiscence included the presence, duration, and number of intraoperative hypotensive periods, and location of anastomosis, with greater odds of dehiscence in anastomoses involving the large intestine.
IBD, location of anastomosis, and intraoperative hypotension are risk factors for intestinal anastomotic dehiscence after SFEEA in dogs. Previously suggested risk factors (low serum albumin concentration, preoperative septic peritonitis, and intestinal foreign body) were not confirmed in this study.
确定犬吻合器功能性端端吻合术（SFEEA）中吻合口裂开的危险因素。
回顾性病例系列研究。
需要进行肠切除术的犬（n = 53）。
回顾了一家机构2001年至2012年期间所有接受肠切除术的犬的病历。当使用胃肠（GIA）和胸腹（TA）吻合器在犬的小肠段或小肠与大肠之间进行功能性端端吻合时，纳入这些手术病例。记录术前、手术和术后因素的相关信息。
53例中有6例（11%）出现吻合口裂开，死亡率为83%。与吻合口裂开显著相关的唯一术前因素是炎症性肠病（IBD）。与吻合口裂开显著相关的手术因素包括术中低血压期的存在、持续时间和次数，以及吻合口位置，涉及大肠的吻合口裂开几率更高。
IBD、吻合口位置和术中低血压是犬SFEEA术后肠吻合口裂开的危险因素。本研究未证实先前提出的危险因素（低血清白蛋白浓度、术前感染性腹膜炎和肠道异物）。
