Abstract
The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors. Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon. Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors. Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.
Highlights
Gastrointestinal biopsies are commonly performed as part of the diagnostic investigation of chronic gastrointestinal disease in small animal veterinary medicine
Information regarding concurrent abdominal surgical procedures was available for 164 cats; of these, 42 (25.6%) had another major abdominal procedure performed at the same time as gastrointestinal biopsy
This study reports a low incidence of definite dehiscence following full-thickness gastrointestinal biopsy in dogs (1%) and cats (1.2%)
Summary
Gastrointestinal biopsies are commonly performed as part of the diagnostic investigation of chronic gastrointestinal disease in small animal veterinary medicine. Gastrointestinal biopsies can either be obtained endoscopically or surgically and there are specific advantages and limitations associated with each of these techniques (Hall 1994). Whilst obtaining an endoscopic gastrointestinal biopsy is a minimally invasive procedure with rapid recovery times, there are limitations to the size, depth and location of the biopsy sample that can be obtained via this method, tissue quality can vary and patient preparation is required (Hall 1994, Willard and others 2001, Jergens and others 2016). A full-thickness surgical gastrointestinal biopsy provides a sample consisting of all layers of the gastrointestinal tract for analysis and can be obtained from any location along the tract. The most significant morbidity associated with full-thickness incision of the gastrointestinal tract is the potential for post-operative intestinal dehiscence and ensuing septic peritonitis (Allen and others 1992, Wylie and Hosgood 1994). The high likelihood of a fatal outcome, if dehiscence of a surgical biopsy site were to occur, necessitates careful case selection along with appropriate pre-operative discussion with the client in order to obtain informed consent in light of the potential risks
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