Daly Betsey, Chandler John C
1College of Veterinary Medicine, Kansas State University, Manhattan, KS.
2WestVet Emergency and Specialty Center, Garden City, ID.
J Am Vet Med Assoc. 2025 Jan 22;263(7):851-858. doi: 10.2460/javma.24.08.0531. Print 2025 Jul 1.
Identify rate and associated risk factors for dehiscence following gastrotomy for foreign material removal.
Medical records from 2 private practice emergency and referral hospitals were reviewed, and history, laboratory values, intraoperative findings, and outcomes were collected on 271 dogs and 31 cats (n = 302).
Hospital A performed 222 procedures and Hospital B performed 80 procedures. Three cats (3 of 31 [10%]) and 20 dogs (20 of 271 [7%]) had intraoperative intestinal perforations. Two cats (2 of 31 [6.5%]) and 7 dogs (7 of 271 [2.6%]) were diagnosed with preoperative septic peritonitis. Concurrent surgical procedures in felines included enterotomy (3 of 31 [10%]), multiple enterotomies (3 of 31 [10%]), intestinal resection and anastomosis (IR&A; 2 of 31 [6%]), and other (1 of 31 [3%]). Concurrent surgical procedures in canines included enterotomy (55 of 271 [20%]), multiple enterotomies (11 of 271 [4%]), IR&A (24 of 271 [9%]), IR&A and enterotomy (1 of 271 [0.4%]), splenectomy (11 of 271 [4%]), and other (50 of 271 [18%]). There was no proven gastrotomy dehiscence. Two patients that did not have follow-up surgery or necropsy before euthanasia developed postoperative septic peritonitis, and gastrotomy dehiscence could not be ruled out as a differential diagnosis. Assuming neither patient, 1 patient, or both patients had gastrotomy dehiscence, the gastrotomy dehiscence rate was 0% to 0.66%. However, these patients also had an IR&A.
Two cases were presumed to have gastrotomy dehiscence, as the authors would rather overestimate the dehiscence rate. However, it is more likely that the IR&A was the dehiscence site rather than the gastrotomy.
Gastrotomy dehiscence rate is low in cats and dogs, and the dehiscence rate reported in this study may be an overestimation.
确定用于取出异物的胃切开术后裂开的发生率及相关危险因素。
回顾了2家私立急诊和转诊医院的病历，收集了271只犬和31只猫（n = 302）的病史、实验室检查值、术中发现及结果。
医院A进行了222例手术，医院B进行了80例手术。3只猫（31只中的3只[10%]）和20只犬（271只中的20只[7%]）术中发生肠穿孔。2只猫（31只中的2只[6.5%]）和7只犬（271只中的7只[2.6%]）被诊断为术前感染性腹膜炎。猫的同期手术包括肠切开术（31只中的3只[10%]）、多次肠切开术（31只中的3只[10%]）、肠切除吻合术（IR&A；31只中的2只[6%]）及其他（31只中的1只[3%]）。犬的同期手术包括肠切开术（271只中的55只[20%]）、多次肠切开术（271只中的11只[4%]）、IR&A（271只中的24只[9%]）、IR&A和肠切开术（271只中的1只[0.4%]）、脾切除术（271只中的11只[4%]）及其他（271只中的50只[18%]）。未证实有胃切开术裂开。2例在安乐死前行后续手术或尸检的患者发生术后感染性腹膜炎，不能排除胃切开术裂开作为鉴别诊断。假设这2例患者均未发生、1例发生或2例均发生胃切开术裂开，胃切开术裂开率为0%至0.66%。然而，这些患者也进行了IR&A。
2例被推测有胃切开术裂开，作者宁愿高估裂开率。然而，更有可能的是裂开部位是IR&A而非胃切开术。
猫和犬的胃切开术裂开率较低，本研究报道的裂开率可能被高估了。
