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Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes.
Veterinary and Comparative Oncology ( IF 2.3 ) Pub Date : 2020-05-26 , DOI: 10.1111/vco.12621
Samuel D Stewart 1 , E J Ehrhart 1 , Rebecca Davies 1 , Chand Khanna 1
Affiliation  

Haemoperitoneum secondary to ruptured splenic tumours can be either benign or malignant in origin. The majority of previous studies of canine haemoperitoneum have been retrospective, which are associated with well‐recognized biases, such as the potential to underappreciate the diversity of outcomes in a complex presentation such as haemoperitoneum. This study seeks to prospectively define perioperative morbidity and mortality of haemoperitoneum in dogs secondary to ruptured splenic masses. Forty dogs with haemoperitoneum secondary to a ruptured splenic mass met the inclusion criteria. As expected, the cohort predominately consisted of older large breed dogs. All dogs underwent preoperative staging and had a splenectomy performed. Histopathologic analysis was performed on the splenic mass, as well as any possible metastatic lesions that were noted intra‐operatively. Perioperative care outside of splenectomy was delivered in specialty practices using current conventional approaches to care (eg, transfusions and anti‐arrhythmic medications). Fifteen dogs (37.5%) had benign splenic tumours and were cured with surgery alone, whereas 62.5% had malignant disease (most often haemangiosarcoma [HSA]). Surgical outcomes were highly favourable in the vast majority of dogs. Indeed, 38 dogs (95%) survived and were discharged after a median hospitalization of 39.5 hours. Independent predictors of longer hospitalization times included receiving a transfusion and the development of an arrhythmia. Although small, this cohort defines distinctive and optimistic perspectives for dogs with haemoperitoneum from splenic tumour rupture. These favourable outcomes from this prospective study are sufficient to ask if larger prospective studies should be conducted to better inform owners during this challenging cancer emergency presentation.

中文翻译:

对脾肿块破裂狗的前瞻性观察研究表明,潜在的恶性肿瘤风险较低,围手术期结果更有利。

脾肿瘤破裂继发的腹腔积血可以是良性的,也可以是恶性的。以前对犬腹腔积血的大多数研究都是回顾性的,这与公认的偏见有关,例如可能低估了复杂表现(如腹腔积血)中结果的多样性。本研究旨在前瞻性地确定继发于脾肿块破裂的犬腹腔积血的围手术期发病率和死亡率。40 只因脾肿块破裂继发腹腔积血的狗符合纳入标准。正如预期的那样,该队列主要由年龄较大的大型犬组成。所有狗都进行了术前分期并进行了脾切除术。对脾肿块进行组织病理学分析,以及术中发现的任何可能的转移性病变。脾切除术之外的围手术期护理是在专业实践中使用当前的常规护理方法(例如,输血和抗心律失常药物)提供的。15 只狗 (37.5%) 患有良性脾肿瘤并仅通过手术治愈,而 62.5% 患有恶性疾病(最常见的是血管肉瘤 [HSA])。绝大多数狗的手术结果非常有利。事实上,38 只狗 (95%) 存活并在平均住院 39.5 小时后出院。住院时间较长的独立预测因素包括接受输血和发生心律失常。尽管规模很小,但该队列为脾肿瘤破裂导致腹腔积血的狗定义了独特而乐观的观点。
更新日期:2020-05-26
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