Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003-2017).

OBJECTIVE: To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs. STUDY DESIGN: Multi-institutional retrospective study. SAMPLE POPULATION: Fifty dogs treated with 78 procedures. METHODS: Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications. RESULTS: Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty-six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114-2805), 8 (16%) were lost to follow-up after 411 days (range, 43-1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3-1212). Median survival time was not reached after a median of 716 days. CONCLUSION: Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures. CLINICAL SIGNIFICANCE: Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long-term survival can be achieved.

Biomechanical evaluation of different numbers, sizes and placement configurations of ligaclips required to secure cellophane bands.

OBJECTIVE: To determine the number, size, and configuration of ligaclips most resistant to tensile forces when applied to cellophane bands. STUDY DESIGN: In vitro mechanical evaluation. SAMPLE POPULATION: Single-layer and triple-layer cellophane bands, 9.0 and 11.5 mm ligaclips. METHODS: Triple-layer bands were secured with a different number (2-5), size (9.0 or 11.5 mm) or configuration (linear or alternating placement) of ligaclips and mechanically tested. Force-deformation curves were generated and yield load in Newtons (N) was determined for each variable. A 3-way analysis of variance with post hoc Tukey's tests was used for statistical comparisons. Yield load for single-layer and triple-layer bands secured with 4 alternating 11.5 mm ligaclips was compared using a paired-sample (independent) t-test with P<.05 considered significant. RESULTS: Mean yield load increased as the number of ligaclips applied increased, but this effect began to plateau after application of the 4th clip. Mean yield load for 11.5 mm ligaclips was significantly higher than for 9.0 mm ligaclips (P<.001) and for the alternating configuration compared with the linear configuration (P<.001). Yield load for 4 alternating 11.5 mm ligaclips applied to triple-layer cellophane bands was significantly greater than the same configuration applied to single-layer cellophane bands (P<.001). CONCLUSION: 11.5 mm ligaclips applied in an alternating configuration and on triple-layer cellophane provided most resistance to tensile forces. The resistance to tensile forces increased significantly as the number of ligaclips applied increased from 1 to 4/band. CLINICAL RELEVANCE: Surgeons should be aware that the number, size, and configuration of ligaclips and cellophane thickness affect their resistance to tensile forces.