Clinical outcomes and complications of tracheal resection and anastomosis in dogs and cats: 20 cases (2009-2022)

OBJECTIVES

To report clinical presentation, short-term outcome and complications of tracheal resection and anastomosis in dogs and cats.

MATERIALS AND METHODS

Clinical records of pets treated with tracheal resection and anastomosis in seven UK-based veterinary referral centres were retrospectively reviewed (2009 to 2022).

RESULTS

Twenty client-owned pets (eight dogs; 12 cats) were included. Clinical signs comprised dyspnoea (n = 15), stridor (n = 5), subcutaneous emphysema (n = 3), pneumothorax and pneumomediastinum (n = 1), coughing (n = 3), regurgitation (n = 1) and exercise intolerance (n = 1). Indication for surgery was traumatic tracheal rupture (n = 5), tracheal avulsion (n = 7), neoplasia (n = 5) and stenosis (n = 3). Complications occurred in 15 patients (75%). Non-anastomotic complications occurred in nine patients and consisted of cough (n = 5), self-resolving laryngeal paralysis (n = 1), surgical site infection (n = 1) and septic shock (n = 2). Anastomotic complications occurred in seven patients and consisted of anastomotic dehiscence (n = 1), tracheal stenosis (n = 4) and fatal respiratory failure (n = 2). Revision surgery was performed in two dogs due to anastomotic dehiscence and stenosis, and tracheal stenting was performed in one cat due to stenosis. Sixteen patients survived to hospital discharge and 14 survived to latest follow-up (median: 119 days; range: 14 to 1744). Outcome was scored as excellent in five, good in seven, fair in two and poor in six patients.

CLINICAL SIGNIFICANCE

Tracheal resection and anastomosis is the surgical technique of choice to reconstruct tracheal defects. Although more than half of the patients recovered well, high morbidity and mortality rates were documented. This may be due to the severe comorbidities affecting most tracheal resection and anastomosis patients, as well as the client's decision against further treatment when facing serious post-operative complications.

Successful tracheoscopy-assisted reconstruction of traumatic tracheal avulsion in a cat

OBJECTIVE

To outline the clinical findings, surgical management, complications, and outcomes in a case of intrathoracic, traumatic, tracheal avulsion.

CASE SUMMARY

A 2-year-old domestic shorthair cat presented with respiratory distress 18 days after a motor vehicle accident. A tracheal avulsion was diagnosed and treated by surgical anastomosis. The initial anastomosis failed. The subsequent tracheoscopic-assisted tracheal anastomosis was successful. The cat had no further episodes of respiratory distress following the second surgery in a 9-month follow-up period.

UNIQUE INFORMATION PROVIDED

This communication describes a complication of intrathoracic, traumatic, tracheal avulsion repair that has not previously been described and the use of tracheoscopy during the subsequent surgical procedure to ensure accurate suture placement.