Peer-reviewed veterinary case report
Surgical methods and outcomes for adrenal tumor removal in 19 dogs
By Knight, Rebekah C et al.·Published in Veterinary surgery : VS·2019·Department of Clinical Sciences and Services, United Kingdom·View original on PubMed →
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Original publication title: Variations in surgical technique for adrenalectomy with caudal vena cava venotomy in 19 dogs.
- Species:
- dog
Plain-English summary
Nineteen dogs with adrenal tumors that had spread into the caudal vena cava (the large vein carrying blood from the lower body) underwent surgery to remove the tumors. Some of these dogs had significant complications, with a mortality rate of 21%. However, the study found that dogs could still have a good outcome even when the tumors extended beyond the liver. The surgery involved techniques that allowed for longer periods of blood vessel occlusion than previously thought possible, and many dogs recovered well after the procedure.
People also search for: dog adrenal tumor surgery · adrenalectomy complications in dogs · dog vena cava tumor treatment
Abstract
OBJECTIVE: To describe surgical techniques, caval occlusion times, and short-term outcomes in dogs undergoing adrenalectomy with caval venotomy. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs undergoing adrenalectomy with caval venotomy between October 1, 2010 and May 31, 2018. METHODS: Medical records of dogs undergoing adrenalectomy with caval venotomy were reviewed for signalment, perioperative management, surgical details, perioperative complications, mortality, and histopathology. Computed tomography images were reviewed to describe tumor morphology and signs of thrombus extension. RESULTS: Nineteen dogs had adrenal tumor thrombi extending into the prehepatic (14 dogs, 74%), hepatic (3 dogs, 16%), and posthepatic (2 dogs, 11%) caudal vena cava. Tumors occurred in left (11) and right (8) adrenal glands. Median caval occlusion was 6.5 minutes (range, 2-25). Two to six vascular tourniquets were used. Venotomy closure was performed under full caval occlusion in 11 dogs and by using a partial occlusion clamp in 8 dogs. Left ureteronephrectomy was performed in 5 dogs. Perioperative mortality rate was 21% (4 dogs). CONCLUSION: Extension of caval tumor thrombus beyond the hepatic hilus did not preclude a good outcome. Longer caval occlusion than has been previously reported was tolerated in some cases. Number of vascular tourniquets used reflected the location of phrenicoabdominal vein insertion on the cava and length of the caval tumor thrombus. Venotomy closure under full occlusion was often required for right adrenal tumors. When required, ureteronephrectomy was left sided. CLINICAL SIGNIFICANCE: Dogs with adrenal tumors extending beyond the hepatic hilus and those requiring a long caval occlusion time can survive adrenalectomy.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30681162/