Clinical Assistant Professor Purdue University College of Veterinary Medicine west lafayette, Indiana
Postoperative Complications Following Apocrine Gland Anal Sac Adenocarcinoma Resection in Dogs. Sterman AA1;2, Butler JR3, Chambers AR4, Dickson RP5, Dornbusch JA6, Mickelson M7;8, Selmic LE6, Scharf VF5, Schlag AN9, Skinner O4, Vinayak A10, Wustefeld Janssens B2;11. 1Purdue University, Department of Veterinary Clinical Sciences, West Lafayette, IN; 2Texas A&M University, Department of Small Animal Clinical Sciences, College Station, TX; 3Care Center, Dayton, OH; 4University of Missouri, Department of Small Animal Surgery, Columbia, MO; 5North Carolina State University, Raleigh, NC; 6The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH; 7University of Missouri, Department of Small Animal Clinical Sciences, Columbia, MO; 8Iowa State University, Department of Clinical Sciences, Ames, IA; 9Mississippi State University, Department of Clinical Sciences, Mississippi State, MS; 10VCA West Coast Specialty and Emergency Animal Hospital, Fountain Valley, CA; 11Colorado State University, Flint Animal Cancer Center and Department of Clinical Science, Fort Collins, CO.
The purpose of the study was to describe the complications associated with surgical resection of primary apocrine gland anal sac adenocarcinoma (AGASACA) tumors. A multi-institutional retrospective cross-sectional cohort study using client-owned dogs with spontaneous disease. Using the Clavien-Dindo classification system, postoperative events were assigned and described. Logistic regression analysis was used to analyze for risk factors for a significant association with complications. One hundred sixty-one dogs were included. The postoperative sequelae, complication, and failure of local control rates specific to the anal sac site was 14%, 17%, and 1%, respectively. The majority (68%) of complications were grade II or higher, requiring some form of intervention. Intraoperative complications were identified in 11 cases (7%) with rectal wall perforation being most common. An intraoperative complication was significantly associated with postoperative complications (P < 0.001; OR 7.4) though rectal wall perforation was the only significant risk factor on regression analysis (P < 0.001; OR 19). Surgical site infection was identified in 20 of 161 (12%) of cases. Local recurrence (LR) occurred in 18% of cases at a median of 374 days (95% CI = 318–430). The only risk factor significantly associated with LR was the presence of vascular or lymphatic invasion (P = 0.008; OR 3). Postoperative complications were infrequent but the risk was significantly increased when there was an intraoperative complication during resection of a primary AGASACA tumor. This study was limited in the retrospective and multi-institutional nature. This study provides information for the clinician regarding risk factors for postoperative complications.