Kohler Rickard J, Arnold Susan A, Eck Daniel J, Thomson Christopher B, Hunt Matthew A, Pluhar G Elizabeth
J Am Vet Med Assoc. 2018 Dec 15;253(12):1594-1603. doi: 10.2460/javma.253.12.1594.
OBJECTIVE To determine incidence of and risk factors for major complications occurring in dogs within 30 days after cytoreductive surgery performed by a single pair of surgeons for treatment of suspected primary intracranial masses. DESIGN Retrospective cohort study. ANIMALS 160 client-owned dogs that underwent cytoreductive surgery for treatment of suspected primary intracranial masses between January 2009 and December 2015 at a veterinary teaching hospital. PROCEDURES Medical records were retrospectively reviewed for complications occurring within 30 days after surgery. Data (eg, signalment, clinical signs, previous treatments, preoperative neurologic examination findings, neuroanatomical location, time from onset of clinical signs to surgery, surgical approach, and histopathologic diagnosis) were analyzed for associations with death and with development of major complications other than death. RESULTS 21 (13.1%) dogs died (11 during hospitalization and 10 after discharge) and 30 (18.8%) developed major complications other than death during the first 30 days after surgery. Dogs with abnormal preoperative neurologic examination findings were more likely to develop complications or die. Dogs undergoing a suboccipital approach were more likely to die. The most common postoperative complications other than death were seizures (n = 18 [11.3%]), worsening of neurologic status (6 [3.8%]), and aspiration pneumonia (6 [3.8%]). CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study provided valuable information on predisposing factors, odds of major complications or death, and incidences of major complications or death in dogs during the first 30 days after undergoing cytoreductive surgery for treatment of suspected primary intracranial masses. Careful case selection may help improve outcomes and minimize complications.
目的 确定由一对外科医生进行减瘤手术治疗疑似原发性颅内肿块后30天内犬发生主要并发症的发生率及危险因素。 设计 回顾性队列研究。 动物 2009年1月至2015年12月在一家兽医教学医院接受减瘤手术治疗疑似原发性颅内肿块的160只客户拥有的犬。 程序 回顾性审查医疗记录以查找术后30天内发生的并发症。分析数据（如特征、临床症状、先前治疗、术前神经学检查结果、神经解剖位置、从临床症状出现到手术的时间、手术入路和组织病理学诊断）与死亡以及除死亡外主要并发症发生情况的关联。 结果 21只（13.1%）犬死亡（11只在住院期间死亡，10只出院后死亡），30只（18.8%）在术后前30天内发生了除死亡外的主要并发症。术前神经学检查结果异常的犬更有可能发生并发症或死亡。接受枕下入路手术的犬更有可能死亡。除死亡外最常见的术后并发症是癫痫发作（n = 18 [11.3%]）、神经状态恶化（6只 [3.8%]）和吸入性肺炎（6只 [3.8%]）。 结论及临床意义 本研究结果为接受减瘤手术治疗疑似原发性颅内肿块的犬在术后前30天内的易感因素、主要并发症或死亡几率以及主要并发症或死亡发生率提供了有价值的信息。仔细选择病例可能有助于改善预后并将并发症降至最低。
