Cat vomiting from esophagus tumor treated with double-flap surgery

Abstract

OBJECTIVE: To describe the clinical application and outcome of the double-flap technique (DFT) for oesophagogastric reconstruction following distal oesophagectomy and proximal gastrectomy in a cat with extensive oesophagogastric leiomyosarcoma. STUDY DESIGN: Case report. PATIENT: A 10-year-old neutered male domestic shorthair cat. CASE DESCRIPTION: Computed tomography revealed a large mass at the oesophagogastric junction in a cat with vomiting and regurgitation. Distal oesophagectomy and proximal gastrectomy were performed, followed by oesophagogastric reconstruction using the DFT, a valve-forming technique involving two seromuscular flaps designed to reduce gastroesophageal reflux. Intraoperative oesophagogastric endoscopy was used to assess anastomotic patency and integrity. OUTCOME: The reconstruction using the DFT was feasible without intraoperative complications after the complete resection of the mass. The operation time was 134 min. The resected mass was histopathologically diagnosed as a leiomyosarcoma. Oral feeding resumed on postoperative Day (POD) 13. Although the cat required frequent small meals due to reduced gastric capacity, vomiting did not occur. No evidence of anastomotic leakage or reflux oesophagitis was observed. After a period of clinical stability, the cat presented on POD 53 with lethargy and anorexia. Metastatic disease was suspected, and the cat succumbed to cancer-associated cachexia on POD 66. CONCLUSIONS: This is the first reported case of oesophagogastric reconstruction using the DFT following extensive resection of the oesophagogastric junction in a cat. The procedure was technically feasible and resulted in functionally effective reconstruction without evidence of reflux or anastomotic complications. The DFT may represent a viable surgical option for feline patients undergoing gastrectomy for oesophagogastric neoplasia.