Ch. 102: Trachea & Bronchi Flashcards
Bird JSAP 2018
A modified temporary tracheostomy in dogs: outcome and complications in 21 dogs (2012 – 2017)
post-op complications?
what increased complication rate?
long-term follow-up?
Postoperative complications = 8/21 dogs (38%) including dislodgement of trach tube 6/21 (29%), obstruction of trach tube 1/21 (5%), & SQ emphysema / pneumomediastinum (5%)
Tube dwell duration of 4 d or longer significantly associated with higher complication rate (58% vs 11%)
All healed by day 14 – long-term follow-up no tracheal stenosis or lar par seen
Gobbetti Vet Sx 2018
Long-term outcome of permanent tracheostomy in 15 dogs with severe laryngeal collapse secondary to BOAS
MST?
major complications?
% 2nd sx?
long-term QOL?
PQ permanent tracheostomy - % complications, MST
- MST 100 days *
- Major complications 80% (12/15) dogs *
death in 8 (53%) (MST 15d)
27 % dogs required revision surgery
Postoperative QOL of 9 dogs markedly improved – stoma mgmt. simple in 8, demanding in 4
Worth JAVMA 2018
Risk factors for temporary tracheostomy tube placement following surgery to alleviate signs of BOAS in dogs
3 more common reasons to need TTTP and % or odds ratio?
Odds of postoperative TTTP increased 30% for each 1 yr increase in patient age
Steroids 5.3 – 10.4 x increased risk of TTTP
Pneumonia – 6.1 x likely to need TTTP
Mortality rate DID NOT DIFFER
Grimes JAVMA 2019
Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies
% major complications?
% revision sx?
overall MST and what shortens?
Major complications in 61% dogs
Revision surgery done in 35% dogs
Overall MST 1825 d
- dogs that received corticosteroids before PT, dogs with tracheal collapse, or older age had shorter MST
Stordalen JSAP 2020
Outcome of temporary tracheostomy tube-placement following surgery for BOAS in 42 dogs
duration of TTT?
% major complication?
% survived to discharge?
Condition more likely to need TTT post-op?
Median duration of placement 2 d (1-7)
Major complication rate 83.3%
40/42 (95%) survived to discharge
High numbers of patients with TTT after revision surgery for BOAS
Suematsu Vet Sx 2019 PQ
Long-term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis
% survived to discharge?
Post-op complications?
Survival 1-3yrs post?
% NOT needing medical management?
98% dogs survived to discharge
Postop complications : lar par (1) DIC (1), recurrent tracheal collapse (2)
Survival rates at 12 mo 96%, 24 mo 86%, 36 mo 86%
Medical mgmt. not required in 89% dogs after surgery
Weisse JAVMA 2019 PQ
Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse
- % survive to discharge and MST?
- % major complications?
- 2 factors that increases survival?
- Impact of mainstem bronchial collapse?
93% (70) survived to hospital discharge; MST 1005d
Major complications needing additional stent placement 47% (33/70)
Male dogs and younger dogs significantly longer survival time than other dogs
Mainstem bronchial collapse at time of stent placement had no significant association with outcome
Congiusta JAVMA 2021
Comparison of short-, intermediate-, and long-term results between dogs with tracheal collapse that underwent multimodal medical management alone and those that underwent tracheal endoluminal stent placement
- can MM alleviate signs?
- factors assoc with shorter MST?
MM alleviated c/s for months to yrs in dogs w/ mild-moderate TC but stent placement should be considered in dogs w/ severe dz
Factors associated sig shorter MST were age >8.8yrs, cardiac dz, emergency exam during intermediate follow up period, dx of pneumonia during intermediate followup period
Hall JSAP 2020
Atypical lateral tracheal collapse in a Yorkshire terrier
treatment?
outcome?
Extraluminal ring prostheses resulted in widening and an immediate improvement in clinical signs
Patient doing well 6 years post-op
Kanemoto JFMS 2023
Retrospective study of feline tracheal mass lesions
location?
etiology?
MST?
Location: cervical tracheal involvement in 16/18
Lymphoma was most often diagnosed (n=15), adenocarcinoma (n=2), and squamous cell carcinoma (n=1)
MST of 214 days
Gibson Vet Sx 2019 PQ
Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic dz secondary to plant awn migration
% abnormalities found with bronchoscopy?
agreement b/w CT + bronch? PQ?
% retrieved via bronch vs. sx?
PQ bronchoscopy and CT for foreign body detection) success rate?
Bronchial abnormalities ID with bronchoscopy in 21/22 dogs (95.4%)
Agreement between CT and bronchoscopy ranged 50% to 81.8% depending on the lung lobe *
37 MPA retrieved via bronchoscopy in 37% dogs, *
39 MPA retrieved at surgery 70.3%
Brisimi Vet Sx 2022
Influence of age on resistance to distraction after tracheal anastomoses in dogs: an ex vivo study
failure force vs. elongation?
mode of failure?
reinforcement?
Tracheal anastomoses failed at lower forces (44.91 N) in immature dogs, but had more elongation (39.75%)
All constructs failed by suture tearing through the annular ligament close to the dorsal tracheal anastomosis ring
Immature dogs may be able to withstand longer tracheal resection, but reinforcement techniques seem mandatory
Walters JAVMA 2021
Diagnosis of a tracheal tear by use of an oxygen analyzer in a dog with cervical trauma
Endotracheal cuff deflated, patient oxygen saturation decreased
Oxygen concentration at the skin wound was investigated with oxygen analyzer
on 100% O2, higher concentration of oxygen at the edge of penetrating neck wound compared with the concentration of oxygen in room air
Joffe JVECC 2020
Successful tracheoscopy-assisted reconstruction of traumatic tracheal avulsion in a cat
Initial surgery failed, then performed tracheoscopic-assisted tracheal anastomosis
Flageollet JSAP 2023
Bronchoscopic findings in dogs with bronchial vegetal foreign bodies: 84 cases (2010-2020)
Main complication?
% that needed surgery?
Retrospective analysis
84 cases were included.
59 dogs (70%) presented during spring and summer.
Cough (77 of 84; 92%) and fever (15 of 84; 18%) were the main clinical signs.
1-10 bronchial vegetal foreign bodies were removed from each dog.
Purulent exudate was observed in the ventral larynx, trachea and bronchi in 49 (65%), 61 (81%) and 71 (95%) dogs, respectively.
Mucosal nodules associated with purulent material within the airways are frequent endoscopic findings in dogs with bronchial vegetal foreign bodies
Mild bleeding was the main complication (58 of 75; 77%) of endoscopic removal, which was successful in 67 of the 84 (80%) cases.
17 dogs (20%) required surgical treatment, as the BVFB was not removable by endoscopy.
