Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991–2000)

• Published in: Journal of the American Veterinary Medical Association Vol. 223; no. 1; pp. 73 - 77
• Main Authors: Ralphs, S. Christopher, Jessen, Carl R, Lipowitz, Alan J
• Format: Journal Article
• Language: English
• Published: United States 01-07-2003
• Subjects: Anastomosis, Surgical - adverse effects; Anastomosis, Surgical - methods; Anastomosis, Surgical - veterinary; Animals; blood; Cat Diseases - epidemiology; Cat Diseases - etiology; Cat Diseases - surgery; Cats; Discriminant Analysis; Dog Diseases - epidemiology; Dog Diseases - etiology; Dog Diseases - surgery; Dogs; Female; foreign bodies; Intestinal Diseases - surgery; Intestinal Diseases - veterinary; Intestines - surgery; Male; peritonitis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - veterinary; Predictive Value of Tests; resection; Retrospective Studies; risk; Risk Factors; serum albumin; Treatment Outcome
• ISSN: 0003-1488; 1943-569X
• DOI: 10.2460/javma.2003.223.73

Objective—To identify factors associated with leakage following intestinal anastomosis in dogs and cats. Design—Retrospective study. Animals—90 dogs and 25 cats. Procedure—Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. Results—Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration ≤ 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs. Conclusions and Clinical Relevance—Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration ≤ 2.5 g/dL. (J Am Vet Med Assoc 2003; 223:73–77).