Surgical management and outcome of a laryngeal myxosarcoma in a dog

Laryngeal neoplasia is rare in dogs and cats, with most information coming from case reports. Animals with laryngeal tumors are presented with dyspnea that does not improve with open-mouth breathing, respiratory stridor, exercise intolerance, dysphagia, and progressive voice change. Diagnosis is confirmed with a laryngeal examination and a biopsy of the mass. Thoracic radiography is recommended for the evaluation of metastasis and aspiration pneumonia. Partial or segmental laryngectomy is performed for a tumor invading one side of the larynx and one vocal cord. When the tumor is large and involves both sides of the larynx, a complete laryngectomy combined with a permanent tracheostomy is required to palliate the clinical signs. Complete laryngectomy has limited utilization in veterinary surgery and the success rate of this surgery is not known in dogs.

A 3‐year‐old French bulldog was presented with a 2‐year history of a progressively worsening stertor and exercise intolerance. Clinical examination was suggestive of brachycephalic obstructive airway syndrome (BOAS). Routine laryngeal examination and computed tomography confirmed changes consistent with BOAS. A folded flap palatoplasty and vertical wedge resection alarplasty were performed. Severe dyspnea and cyanosis developed during recovery necessitating emergency intubation, and temporary tracheostomy was performed. A silicone tracheal stoma stent was placed instead of a tracheostomy tube. The silicone stoma stent was removed after 48 hours, and the patient remained hospitalised for observation for further 8 hours. Before discharge, the patient became severely distressed during IV canula removal. Rapid onset of severe subcutaneous emphysema and dyspnea necessitated emergency induction and intubation. Thoracic radiographs revealed a left‐sided pneumothorax. Following thoracostomy tube placement and drainage, a permanent tracheostomy was performed and the dog was discharged from hospital the following day.

Transendoscopic neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used to treat 12 standing horses with epiglottic entrapment (EE) or dorsal displacement of the soft palate (DDSP), or both. In four horses, transendoscopic laser staphylectomy was performed. The most common presenting complaints were respiratory stridor, cough, and exercise intolerance. Ten horses with EE healed without epiglottic complications; in one horse, partial adhesion of the aryepiglottic fold to one side of the epiglottis was corrected surgically through a laryngotomy incision. One horse with DDSP had no further signs, one continued to have continual DDSP, and two had induced DDSP. Transendoscopic Nd:YAG laser proved to be a feasible means of correcting EE and selected cases of DDSP.

Objective: This study aims to determine the effect of deep breathing and coughing exercise training before surgery on respiratory functions and exercise tolerance in patients with open-heart surgery in the postoperative period. Background: The decrease in respiratory functions and activity tolerance of patients after open heart surgeries reveals the need to improve this situation with effective interventions. Methods: The quasi-experimental study was conducted with 80 patients undergoing open-heart surgery. Data were collected using the patient information form and the patient follow-up form. The patients were taught deep breathing and coughing exercises before the open-heart surgery and were supported in exercising regularly before and after the surgery. The patients' respiratory functions and exercise tolerance were measured and recorded via the patient follow-up form. Results: It was determined that the respiratory capacity, distance, time, and walking speed of the patients in the experimental group during the postoperative period were significantly higher than the control group. Conclusion: Substantially, deep breathing and coughing exercise training administered before surgery to patients undergoing open heart surgery improved respiratory functions and exercise tolerance in the postoperative period. It is recommended that nurses working in open-heart surgery clinics should plan deep breathing and coughing exercise training in the preoperative period and administer them regularly to the patients. Implications for research, policy, and practice: Patients who will undergo open heart surgery should be trained by nurses in the preoperative period. Nurses should teach these patients deep breathing and coughing exercises. In the postoperative period, it should be checked regularly whether the patients do exercises or not. What is already known about the topic? It is important to teach and practice breathing exercises in patients who will have open heart surgery. Respiratory training given by nurses in the preoperative period contributes to the management of the postoperative process. What this paper adds: This article demonstrates the importance of preoperative education for patients undergoing open heart surgery. In this study, it is shown that open heart surgery has a negative effect on the respiratory capacity and exercise tolerance of the patients. In addition, in this study, it is shown that the respiratory capacity and exercise tolerance of the patients who were taught preoperative breathing exercises and who performed the exercises in the postoperative period increased in the postoperative period.

To report our experience in the surgical management of severe injuries of the gastrointestinal tract due to corrosive ingestion. A retrospective review of patients who underwent emergency surgery for severe gastrointestinal injuries following corrosive ingestion between 1983 and 2010 was carried out. Data was extracted from a prospectively maintained esophageal disease database. Severe corrosive injuries were defined as full thickness necrosis with perforation of the esophagus or the stomach (with or without involvement of the adjacent viscera) with resultant mediastinitis or peritonitis. Between 1983 and 2010, 209 patients with corrosive injury of the esophagus were managed. Of these, 13 (6.2%) patients underwent emergency surgery for severe corrosive injury. The median age of the patients was 22 years and the median interval between ingestion of the corrosive substance and surgery was 24 h. The surgical procedures done included esophagogastrectomy alone (n = 6), esophagogastrectomy with duodenectomy (n = 4), esophagogastrectomy with pancreaticoduodenectomy (n = 1), esophagogastrectomy with splenectomy (n = 1) and distal gastrectomy with duodenectomy (n = 1). Two patients died in the postoperative period and one after discharge awaiting the second surgery. The factors significantly predictive of mortality following such an injury included renal failure at the time of initial presentation, presence of metabolic acidosis, delay of more than 24 h between corrosive ingestion and surgery, and corrosive induced adjacent organ injury (pancreatic) (P < 0.001, 0.02, 0.005 and 0.015 respectively). Ten patients underwent subsequent surgery for restoration of the alimentary tract continuity with a colonic pull-up (n = 8) and gastrojejunostomy (n = 1). In one patient, the attempted colon pull-up failed due to extensive scarring of the mesocolon. The median follow up (following restoration of continuity of the gastrointestinal tract) was 36.5 mo. One patient developed dysphagia due to a stricture at the anastomotic site, which was successfully managed by dilatation. Another patient developed severe aspiration, necessitating laryngeal inlet closure and permanent tracheostomy, and 3 patients complained of occasional regurgitation. Management of severe corrosive injury involves prompt resuscitation and urgent surgical debridement. Although the subsequent restoration of continuity may be complicated and may not always be possible, long term outcomes are acceptable in the majority.

To report the surgical technique and outcome of total laryngectomy in a single clinical case. Case report. A 5-year-old female spayed domestic shorthair cat. A cat presented for acute, severe respiratory distress caused by an invasive laryngeal mass. Incisional biopsy was indicative of sarcoma. Computed tomography of head, neck, and thorax was performed revealing no evidence of metastasis. A total laryngectomy and permanent tracheostomy were performed, and the cat could breathe without difficulties immediately postoperatively. Histopathology confirmed a laryngeal low-grade peripheral nerve sheath tumor (PNST). Surgical margins were free of tumor cells. Surgical revision of the tracheostomy stoma due to obstructive granulation tissue was necessary 24 days after the initial surgery. Nine days after revision surgery, the cat was discharged from the hospital. No evidence of local recurrence or metastasis was detected on repeat computed tomography of the head, neck, and thorax at 6months, nor on chest radiographs at 12 months postoperatively. At the time of writing (13 months postoperatively), the cat is still alive with a good quality of life. Total laryngectomy with permanent tracheostomy allowed the complete removal of an obstructive laryngeal PNST and provided a good quality of life in a cat. To the authors' knowledge, this case report represents the first detailed description of the surgical procedure and clinical outcome for a total laryngectomy in a cat.

This report aimed to study symptoms and causes of brachycephalic obstructive airway syndrome (BOAS) in brachycephalic dogs and to determine appropriate surgical procedures for these symptoms by reviewing literatures and examining four case studies conducted at Veterinary Specialist Service Hospital, Underwood, Queensland, Australia. The cases included a 6-year 3-month-old Staffordshire Bull Terrier (case 1), a 1-year 5-month-old French Bulldog (case 2), an 8-month-old French Bulldog (case 3), and an 8-year 8-month Pug (case 4). Those dogs went to the Veterinary Specialist Service in a worsen state of respiratory problems, including the upper respiratory noise (case 1, 2, 3), decrease in exercise tolerance, respiratory struggling (case 1, 3), regurgitation (case 1), coughing, sleeping difficulty, respiratory stridor (case 2), nasal discharge, dyspnea, bloating, and tachypnea (case 4). Examinations revealed the causes including the elongated soft palate (case 1, 2, 3, 4), stenotic nostrils (case 2, 3, 4), tonsils inflammation (case 3) and everted laryngeal saccules (case 4). After surgery, the dogs were recovered in intensive care unit within 2 days, and then discharged. Scheduled re-examination one week later showed improvement in the respiratory health in all cases. Overall, major complications occur in 10% of cases; however, this surgery is vital and can be totally applied in Vietnam where brachycephalic dogs have become a popular companion.

Chest injuries sustained during armed conflict have a high mortality rate and are accompanied by pulmonary dysfunction. Pulmonary contusion is manifested by rupture of pulmonary parenchyma, atelectasis, and hemorrhages in pulmonary parenchyma. The treatment strategy for such patients includes anesthesia, management of acute respiratory failure, treatment of infectious complications, sanation of airways, and rehabilitation measures. One of the goals of such interventions is the elimination of respiratory biomechanics disorders. It is recommended to use respiratory exercisers with a threshold level of resistance for the process of inhalation and exhalation to train respiratory muscles. At the Main Military Clinical Hospital named after N.N. Burdenko the possibility of application of the respiratory simulator "Universal-2011" as a therapeutic physical training tool in the hospital phase of treatment of patients with thoracic trauma was studied. The efficacy of the carried activities was evaluated by functional tests of tolerance to hyper- and hypocapnia of Stange and Gench and the assessment of thoracic cage excursion. The experience of using a respiratory exerciser was observed to be positive. All 25 patients fulfilled the planned program with the achievement of improvement of external respiratory function and exercise tolerance.

Yoga in Burn: Role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full-thickness circumferential burns of the chest

Introduction In breast cancer patients converting from clinically positive (cN+) to negative (ycN0) lymph node status after neoadjuvant chemotherapy (NACT), surgical staging by axillary lymph node dissection (ALND) is increasingly replaced by less invasive procedures like targeted axillary dissection (TAD) or sentinel lymph node biopsy (SLNB), possibly followed by completion ALND or regional radiotherapy if positive. Prospective data comparing oncologic safety of different procedures as a primary approach after NACT are currently scarce. We report 3-year axillary recurrence-free survival (ARFS) as the first primary endpoint analysis of the AXSANA/EUBREAST 3(R) study (NCT04373655, www.eubreast.org/axsana), initiated by the European Breast Cancer Research Association of Surgical Trialists (EUBREAST e.V.). Methods In an international multicenter cohort study, patients with cN+ breast cancer who receive at least four cycles of NACT and convert to ycN0 are eligible. Axillary staging after NACT is performed according to institutional routine. Grouping of patients was based on the primary staging procedure, not on final axillary surgery, e.g., completion ALND following a positive SLNB was classified as SLNB. Co-primary endpoints are ARFS, invasive breast cancer-specific survival (iBCSS), and patient-reported quality of life. Data entry is systematically monitored. Less extensive axillary staging procedures as first surgery after NACT (TAD, SLNB, targeted lymph node biopsy (TLNB)) are considered non-inferior to staging by ALND if the lower bound of a two-sided 90% confidence interval (CI) around 3-year ARFS exceeds 97%. 750 patients were required per group (TAD/SLNB/TLNB vs ALND). Results From June 2020 to April 2025, 6,474 patients (26 countries, 288 study sites) were enrolled, 2,632 of whom had completed surgery by December 31, 2023 and were selected for analysis. Primary staging procedure was ALND in 799 patients (30.4%) and less invasive procedures (419 SLNB, 1399 TAD, 15 TLNB) in 1,833 (69.6%). Nodal complete pathological response was reported in 1,345 patients (51.1%): 423 (31.4%) after ALND and 922 (68.6%) after TAD/SLNB/TLNB. 2489 patients (94.6%) received post-NACT nodal radiotherapy: 759 (95.0%) after ALND and 1730 (94.4%) after TAD/SLNB/TLNB. After a median follow-up of 2.0 years (range, 0.01-4.5), 15 axillary recurrences occurred after TAD/SLNB/TLNB and 4 after ALND (4.2 vs 2.5 events/1000 person-years, p=0.351). 3-year ARFS was 99.2% (95% CI 98.2-100.0) after ALND and 98.8% (95% CI 98.1-99.5) after TAD/SLNB/TLNB. For TAD/SLNB/TLNB, the lower bound of a 90% CI was 98.2%. After SLNB, 1 axillary recurrence occurred and 14 after TAD (1.2 vs 5.1 events/1000 person-years, p=0.132). Results were similar upon controlling for clinicopathological risk factors and neoadjuvant treatment or exclusion of 143 patients without radiotherapy. iBCSS at 3 years was 85.7% (95% CI 82.6-89.0) for ALND and 88.2% (95% CI 86.0-90.3) for TAD/SLNB/TLNB. Conclusion In patients who convert from clinically node-positive to node-negative breast cancer, the AXSANA study showed that less invasive surgical staging procedures are associated with a low axillary recurrence rate, not inferior to ALND after 3 years, regardless of initial tumor stage or subtype. These findings reinforce efforts to minimize surgical morbidity without compromising oncologic outcomes. Citation Format: T. Kühn, M. Banys-Paluchowski, N. Ditsch, E. Stickeler, M. Hauptmann, J. Schroth, G. Karadeniz Cakmak, M. Hahn, M. Thill, T. Reimer, S. Fröhlich, E. Schmidt, M. Lux, H. Kolberg, I. Rubio, M. Gasparri, M. Kontos, E. Bonci, L. Niinikoski, D. Murawa, D. Pinto, F. Peintinger, E. Schlichting, H. Nina, H. Valiyeva, M. Vanhoeij, L. Rebaza, B. Aktas Sezen, K. Jursik, G. Kadayaprath, L. Dostalek, A. Kothari, A. Perhavec, T. Ivanov, D. Zippel, S. Thongvitokomarn, B. Adamczyk, M. Gurleyik, D. Watermann, M. Porpiglia, S. Grasshoff, S. Loibl, D. Krug, A. Lebeau, R. Di Micco, O. Gentilini, J. de Boniface, S. Hartmann, AXSANA study group.. More versus less invasive axillary surgical staging procedures in breast cancer patients converting from a clinically node-positive to a clinically node-negative stage through neoadjuvant chemotherapy - primary endpoint analysis of the international prospective multicenter AXSANA/EUBREAST 3(R)study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr GS2-01.

Entrenamiento de los músculos inspiratorios en la enfermedad pulmonar obstructiva crónica. Su impacto sobre las alteraciones funcionales y sobre la tolerancia al ejercicio

BackgroundIntestinal obstruction is the most common acute abdominal disorders in children requiring emergency surgical management. Although surgical management remained the best treatment modality for intestinal obstruction, significant subset of children undergoing surgical management experiences unfavorable management outcomes. Unfavorable surgical management outcomes pose substantial impacts in children, their families, and the society. However, there has been limited evidence regarding the surgical management outcomes of intestinal obstruction among children in developing countries lie Ethiopia.ObjectiveThis study aims to assess surgical management outcomes of intestinal obstruction and its associated factors among children aged less than 15 years in eastern Amhara comprehensive specialized hospitals.MethodsInstitutional-based cross-sectional study design was employed among 262 children aged less than 15 years. The study participants were selected by simple random sampling techniques after proportional allocation of the sample to the study hospitals. Data was collected using a pretested data collection checklist and it was entered to Epi Data version 4.2 and analyzed using SPSS version 25 software. Variables with p-value of < 0.25 in the bi-variable analysis were entered into multi-variable logistic regression analyses. Finally, variables with p-value < 0.05 were declared to have a significant association with the outcome variable.ResultTwo hundred and sixty-two (262) children were included with a response rate of 100%. The finding reveals that nearly one third of children undergoing surgical management for intestinal obstruction (32.1%, 95% CI 26.3, 37.8) experienced unfavorable surgical management outcomes. The study indicated that gangrenous bowel (AOR:4.47, 95%CI:1.8, 11.1), malnutrition (AOR:4.16, 95% CI:1.77, 9.81), length of hospital stays > 7 days (AOR:3.89, 95% CI:1.69, 8.95), delay of surgery > 24 h (AOR:3.27, 95% CI:1.27, 8.42), and duration of surgery > 2 h (AOR:2.61, 95%CI:1.16, 5.88) were the risk factors for unfavorable surgical management outcome of intestinal obstruction.ConclusionThe magnitude of unfavorable surgical outcome is higher than the expected rate nearly one in three children experience unfavorable surgical management outcome following surgical management of intestinal obstruction. The risk factors identified are mainly preventable which includes gangrenous bowel, malnutrition, prolonged hospital stay, delayed surgery after admission, and prolonged duration of surgery. Early identification and treatment of intestinal obstruction is recommended. In addition, implementation of standardized pre and postoperative care protocols will be needed to achieve favorable surgical management outcome.

Summary Nasopharyngeal cicatrices were observed endoscopically in 47 horses examined because of abnormal respiratory noises and/or exercise intolerance. A review of these cases revealed a correlation between cicatrization and age, sex, and the presence of other upper airway abnormalities. The age of affected horses ranged from 6 to 21 years, with a mean age of 12.7 ± 7.8 (± 2 sd) years. Females were affected 2.7 times more frequently than males. Abnormalities commonly observed with a nasopharyngeal cicatrix included chondritis of the arytenoid cartilage, epiglottic deformity, and deformity of the guttural pouch openings. The nasopharyngeal cicatrix was responsible for respiratory obstruction in only 3 horses. Treatment for the cicatrix was not performed on any horse in this series. Generalized nasopharyngeal and laryngeal inflammation were postulated as causes of the cicatrices and associated abnormalities.

Upper airway disorders are a major cause of chronic respiratory signs in dogs, often presenting with overlapping clinical features that challenge diagnosis and management in practice. Nasal disease commonly manifests with discharge, sneezing, epistaxis, facial deformity, and airflow reduction, with differentials including neoplasia, fungal rhinitis, inflammatory rhinitis, dental disease, and systemic illnesses. Thorough history, targeted physical examination, advanced imaging, rhinoscopy, and histopathology form the backbone of diagnostic workup, guiding specific interventions. Laryngeal diseases such as laryngeal paralysis, laryngeal collapse, and laryngeal masses lead to upper airway obstruction, stridor, exercise intolerance, and potentially life-threatening dyspnea; management ranges from emergency stabilization to surgical procedures like arytenoid lateralization or permanent tracheostomy. Tracheal collapse and bronchomalacia in small breeds produce a characteristic chronic honking cough and dynamic airway obstruction, requiring long?term medical management, environmental modification, and, in refractory cases, stenting or ring placement. Brachycephalic obstructive airway syndrome in short?muzzled breeds reflects congenital anatomical compromise, with progressive secondary changes that necessitate early surgical correction and lifelong management to optimize quality of life.

A three-year-old male golden retriever had had progressive dyspnoea, exercise intolerance, stridor, and a modified bark for five months. A mass 2 cm in diameter was present dorsal to the...