Brisson Brigitte A, Wainberg Shannon H, Malek Sarah, Reabel Stephanie, Defarges Alice, Sears William C
J Am Vet Med Assoc. 2018 Feb 1;252(3):301-308. doi: 10.2460/javma.252.3.301.
OBJECTIVE To determine risk factors for surgical intervention, complications, and outcome in dogs with an esophageal foreign body (EFB). DESIGN Retrospective observational study. ANIMALS 224 incidents of EFB in 223 dogs evaluated at a veterinary teaching hospital from 1995 through 2014. PROCEDURES Hospital records were reviewed to collect data regarding signalment, history, clinical signs, EFB type and location, procedures, complications, and outcomes. Breed distributions were compared between dogs with EFB and the entire canine patient population during the study period. Variables were tested for associations with each other and with outcomes. RESULTS Terrier breeds were most common (71/233 [30.5%]). Duration of EFB entrapment, body weight, anorexia, lethargy, rectal temperature, and esophageal perforation were associated with the need for surgical intervention. Older age, longer duration of EFB entrapment, and perforation were associated with a poorer prognosis. Endoscopic retrieval or advancement into the stomach was successful for 183 of 219 (83.6%) EFBs, and 16 of 143 (11.2%) entrapments resulted in postprocedural esophageal stricture. Overall median duration of hospitalization was brief (1 day), and the need for surgical intervention was associated with a longer duration. Overall mortality rate was 5.4% (12/223); 90 of 102 (88.2%) dogs with a median follow-up period of 27 months after EFB treatment had an excellent outcome. CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that endoscopic EFB retrieval remains the initial treatment option of choice for affected dogs, provided that esophageal perforation does not necessitate surgical intervention. Although esophageal stricture formation was the most common complication, the overall rate of this outcome was low.
目的 确定患有食管异物(EFB)的犬只进行手术干预、发生并发症及预后的危险因素。 设计 回顾性观察研究。 动物 1995年至2014年在一家兽医教学医院评估的223只犬只发生的224例EFB事件。 程序 查阅医院记录,收集有关信号、病史、临床症状、EFB类型和位置、程序、并发症及预后的数据。比较研究期间患有EFB的犬只与整个犬类患者群体的品种分布。对变量进行相互关联及与预后关联的测试。 结果 梗犬品种最为常见(71/233 [30.5%])。EFB嵌顿持续时间、体重、厌食、嗜睡、直肠温度及食管穿孔与手术干预需求相关。年龄较大、EFB嵌顿持续时间较长及穿孔与预后较差相关。219例EFB中有183例(83.6%)通过内镜取出或推进至胃内成功处理,143例嵌顿中有16例(11.2%)术后发生食管狭窄。总体住院中位时间较短(1天),手术干预需求与住院时间较长相关。总体死亡率为5.4%(12/223);102只犬中90只(88.2%)在EFB治疗后中位随访27个月,预后良好。 结论及临床意义 研究结果表明,只要食管穿孔无需手术干预,内镜下取出EFB仍是患犬的首选初始治疗方法。虽然食管狭窄形成是最常见的并发症,但该结果的总体发生率较低。