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Surgical management and outcome following adrenalectomy : a retrospective case study in 16 dogs, 2008-2018

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Resumo:Primary neoplasms of the adrenal gland might represent more than 1-2% of all canine tumours and can originate various worrisome clinical presentations; hence why adrenalectomy is generally the treatment of choice. Identification of prognostic factors with occasional uncertainty or contradictions among different authors renders further investigations welcomed. A retrospective study was conducted in 16 dogs undergoing adrenalectomy with the aim to describe the clinical features, surgical management and outcome. Review of clinical records and interviews with owners and veterinarians involved were performed to register clinical variables, such as, signalment, relevant history, clinical signs, laboratory, imaging and surgical findings, histopathology results, and outcome. The median survival time was calculated through Kaplan-Meier estimate. Intra- (92%) and postoperative (67%) complications, and perioperative mortality (31%) rates were comparable to recent studies; as was the median survival time (419 days), with 64% of long-term survivors living for more than 1 year, up to 3 years, approximately. This case series emphasizes that if dogs survive the immediate perioperative period, long-term outcome is generally good with possibility of prolonged survival times, as local or distant tumour recurrence appears to be low. This study also promotes awareness of adrenal incidentalomas (25%) and emergency clinical presentations (19%). Outcome predictors such as age of patients with phaeochromocytomas, size of tumour, surgeon’s experience in dealing with caval invasion, presence of metastasis at surgery, acute adrenal haemorrhage, major intraoperative haemorrhage, and postoperative disseminated intravascular coagulopathy must be considered in the approach to these cases.
Autores principais:Silva, Marta Mariano da
Assunto:dog adrenal gland tumour adrenalectomy incidentaloma rupture surgery cão tumor da glândula adrenal adrenalectomia incidentaloma rotura cirurgia
Ano:2018
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso aberto
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa
Descrição
Resumo:Primary neoplasms of the adrenal gland might represent more than 1-2% of all canine tumours and can originate various worrisome clinical presentations; hence why adrenalectomy is generally the treatment of choice. Identification of prognostic factors with occasional uncertainty or contradictions among different authors renders further investigations welcomed. A retrospective study was conducted in 16 dogs undergoing adrenalectomy with the aim to describe the clinical features, surgical management and outcome. Review of clinical records and interviews with owners and veterinarians involved were performed to register clinical variables, such as, signalment, relevant history, clinical signs, laboratory, imaging and surgical findings, histopathology results, and outcome. The median survival time was calculated through Kaplan-Meier estimate. Intra- (92%) and postoperative (67%) complications, and perioperative mortality (31%) rates were comparable to recent studies; as was the median survival time (419 days), with 64% of long-term survivors living for more than 1 year, up to 3 years, approximately. This case series emphasizes that if dogs survive the immediate perioperative period, long-term outcome is generally good with possibility of prolonged survival times, as local or distant tumour recurrence appears to be low. This study also promotes awareness of adrenal incidentalomas (25%) and emergency clinical presentations (19%). Outcome predictors such as age of patients with phaeochromocytomas, size of tumour, surgeon’s experience in dealing with caval invasion, presence of metastasis at surgery, acute adrenal haemorrhage, major intraoperative haemorrhage, and postoperative disseminated intravascular coagulopathy must be considered in the approach to these cases.