Premium
Temporary end‐on colostomy as a treatment for anastomotic dehiscence after a transanal rectal pull‐through procedure in a dog
Author(s) -
Cinti Filippo,
Pisani Guido
Publication year - 2019
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13152
Subject(s) - medicine , colostomy , dehiscence , surgery , anastomosis , stoma (medicine) , colorectal surgery , abdominal surgery
Objective To describe a temporary end‐on colostomy to treat the dehiscence of a transanal rectal pull‐through in a dog. Study design Case report Animal A 7‐year‐old intact female Australian shepherd dog that was treated for a rectal adenocarcinoma with a transanal rectal pull‐through. Methods Partial dehiscence of the previous end‐to‐end colorectal anastomosis and formation of a perianal sinus tract were diagnosed 4 days after surgery. A pararectal approach was used to revise the surgery with debridement of the sinus tract, rectal wall reconstruction with single interrupted sutures, and placement of a passive drain. Dehiscence occurred 2 days later. The colon was transected cranial to the pelvic brim, and each stump was oversewn prior to salvage temporary end‐on colostomy. Postoperative care included analgesia, antibiotic therapy, and local care of the perineal/perianal area and colostomy site. After 90 days, the perineal/perianal sinus tract had healed, the colostomy was eliminated, and an end‐to‐end anastomosis of the colon was performed. Results Management of postoperative complications focused on dermatitis of the stoma and perineal/perianal area, stoma incontinence, and perineal/perianal medications of the sinus tract. One year after the final surgery, the dog had occasional episodes of fecal incontinence and a good quality of life without other complications. Conclusion Use of a temporary end‐on colostomy prior to revision surgery led to a satisfactory outcome but required long and challenging postoperative management. Clinical significance Temporary end‐on colostomy may be an option to manage dehiscence and potential recurrent stenosis after transanal rectal pull‐through in dogs.