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未接受术前药物治疗的肾上腺肿瘤犬肾上腺切除术后的短期结局

Short-term outcome of adrenalectomy in dogs with adrenal gland tumours that did not receive pre-operative medical management.

作者信息

Appelgrein C, Hosgood G, Drynan E, Nesbitt A

机构信息

School of Veterinary Medicine, Murdoch University, Perth, Australia.

出版信息

Aust Vet J. 2020 Sep;98(9):449-454. doi: 10.1111/avj.12991. Epub 2020 Jun 24.

Abstract

OBJECTIVE

Review medical records of dogs that underwent adrenalectomy without pre-operative medical management, to examine the peri-operative morbidity and mortality.

DESIGN

Case series of 65 dogs.

METHODS

Medical records were reviewed. Features recorded included the histologic diagnosis, intra-operative hypertension or tachycardia, requirement for cavotomy, administration of intra- and post-operative corticosteroids, performance of additional surgery and the occurrence of peri-operative complications. Dogs requiring emergency surgery were excluded.

RESULTS

Of the 65 dogs, 49 had adrenocortical tumours (11 bilateral), 13 had pheochromocytomas (one bilateral) and three dogs had tumours in both adrenal glands of a different tumour type. Five dogs had caudal vena cava invasion and 33 had additional procedures performed at the same time. Mortality occurred in 1/65 dogs (1.5%; 95% CI 0.03%-8.2%), major complications were identified in 1/65 dogs (1.5%; 95% CI 0.03%-8.2%) and minor complications occurred in 10/53 dogs (15%; 95% CI 8.6%-26%).

CONCLUSION

Based on the limited peri-operative complications and low mortality in this pre-operatively untreated cohort, and based on critique of the available literature, the added value afforded by pre-operative treatment is questioned. With appropriate management, adrenal tumours can be removed with few peri-operative complications and low mortality.

摘要

目的

回顾未进行术前药物治疗而接受肾上腺切除术的犬只的病历,以检查围手术期的发病率和死亡率。

设计

65只犬的病例系列。

方法

回顾病历。记录的特征包括组织学诊断、术中高血压或心动过速、开胸需求、术中和术后皮质类固醇的使用、额外手术的实施以及围手术期并发症的发生情况。需要急诊手术的犬只被排除。

结果

65只犬中,49只患有肾上腺皮质肿瘤(11只为双侧),13只患有嗜铬细胞瘤(1只为双侧),3只犬双侧肾上腺患有不同类型的肿瘤。5只犬出现尾腔静脉侵犯,33只犬同时进行了额外手术。65只犬中有1只死亡(1.5%;95%可信区间0.03%-8.2%),65只犬中有1只出现严重并发症(1.5%;95%可信区间0.03%-8.2%),53只犬中有10只出现轻微并发症(15%;95%可信区间8.6%-26%)。

结论

基于该术前未治疗队列中有限的围手术期并发症和低死亡率,以及对现有文献的批评,术前治疗的附加价值受到质疑。通过适当的管理,肾上腺肿瘤可以在围手术期并发症少、死亡率低的情况下切除。

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