MedVet Medical & Cancer Center for Pets, Worthington, Ohio, USA.
Vet Surg. 2024 Jan;53(1):122-130. doi: 10.1111/vsu.14002. Epub 2023 Jul 18.
To compare mortality of dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide (CO ) laser, and bipolar vessel sealing device (BVSD) techniques for the treatment of brachycephalic obstructive airway syndrome (BOAS).
Retrospective multicenter cohort study.
A total of 606 client-owned English bulldogs, French bulldogs, and pugs.
Medical records from 2011 to 2021 were reviewed for signalment, history, surgical technique, length of hospitalization, and complications. Multivariate statistical analysis was performed to compare odds of mortality between the three techniques of staphylectomy.
The overall mortality rate was 24/606 (4.0%). Of those 24 dogs, staphylectomy was performed with BVSD technique in 13 cases, with CO laser in nine, and using conventional incisional technique in two. Nine dogs were graded II or III laryngeal collapse, 14 were graded I, and one was unknown. BVSD technique was associated with mortality prior to discharge compared to the other two techniques (OR = 6.0, 95% CI: 1.3-28.4, p = .023). No differences were detected between conventional incisional and CO laser techniques. Concurrent higher grade (stage II or III) laryngeal collapse was independently associated with mortality prior to discharge (OR = 4.6, 95% CI: 1.8-11.8, p = .002).
The use of BVSD and grade of laryngeal collapse were associated with a higher risk of perioperative mortality.
Clinical studies using a randomized trial design should be conducted to further determine the putative influence of surgical instrumentation in the perioperative mortality rate following multilevel surgery in dogs with BOAS.
比较使用传统切开术、二氧化碳(CO)激光和双极血管密封装置(BVSD)对短头气道阻塞综合征(BOAS)进行部分环甲切除术的犬的死亡率。
回顾性多中心队列研究。
共有 606 只英国斗牛犬、法国斗牛犬和哈巴狗的患犬。
对 2011 年至 2021 年的病历进行了回顾,包括品种、病史、手术技术、住院时间和并发症。进行多变量统计分析,以比较三种环甲切除术技术之间的死亡率。
总死亡率为 24/606(4.0%)。在这 24 只犬中,13 例使用 BVSD 技术进行环甲切除术,9 例使用 CO 激光,2 例使用传统切开术。9 只犬为 II 级或 III 级喉塌陷,14 只为 I 级,1 只为未知。与其他两种技术相比,BVSD 技术在出院前与死亡率相关(OR=6.0,95%CI:1.3-28.4,p=0.023)。在传统切开术和 CO 激光技术之间未检测到差异。并发较高等级(II 级或 III 级)喉塌陷与出院前死亡率独立相关(OR=4.6,95%CI:1.8-11.8,p=0.002)。
BVSD 的使用和喉塌陷的等级与围手术期死亡率的风险增加相关。
应进行使用随机试验设计的临床研究,以进一步确定在 BOAS 犬多水平手术后,手术仪器对围手术期死亡率的潜在影响。