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Analysis of risk factors associated with complications following mandibulectomy and maxillectomy in dogs

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  • 1 From the Department of Surgery, Angell Animal Medical Center, Jamaica Plain, MA 02130
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, OH 43210
  • | 3 Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801
  • | 4 Department of Surgery, Texas A&M Veterinary Medical Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
  • | 5 Department of Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602
  • | 6 Department of Surgery, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada
  • | 7 Department of Surgery, Animal Medical Center, New York, NY 10065
  • | 8 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616

Abstract

OBJECTIVE

To provide information about complication rates and the risk factors for complications with mandibulectomy and maxillectomy procedures in dogs.

ANIMALS

459 client-owned dogs that underwent a mandibulectomy or maxillectomy between January 1, 2007, and January 1, 2018.

PROCEDURES

Inclusion criteria included a complete medical record that contained an anesthesia record, surgical report, available histopathology results, and results of CBC and serum biochemical analysis before surgery. A minimum follow-up of 90 days after surgery was required.

RESULTS

271 complications occurred in 171 of 459 (37.3%) dogs. Eighteen complications were not given a severity description. Of the remaining 253 complications, most were considered minor (157/253 [62.1%]). Multivariable logistic regression analysis revealed that only increased surgical time had a significant (OR, 1.36; 95% CI, 1.12 to 1.54) association with the occurrence of ≥ 1 complication. For each additional hour of surgery, the odds of complications increased by 36%. Preoperative radiation therapy or chemotherapy increased the odds of incisional dehiscence or oral fistula formation (OR, 3.0; 95% CI, 1.3 to 7.2). Additionally, undergoing maxillectomy, compared with mandibulectomy, increased the odds of incisional dehiscence or oral fistula formation (OR, 1.8; 95% CI, 1.1 to 3.1). Two hundred forty-four of 271 (90.0%) complications occurred in the perioperative period (0 to 3 months after surgery).

CONCLUSIONS AND CLINICAL RELEVANCE

Compared with mandibulectomy, performing maxillectomy increased the risk for incisional dehiscence or oral fistula formation. Mandibulectomy and maxillectomy had a moderate risk for a complication.

Abstract

OBJECTIVE

To provide information about complication rates and the risk factors for complications with mandibulectomy and maxillectomy procedures in dogs.

ANIMALS

459 client-owned dogs that underwent a mandibulectomy or maxillectomy between January 1, 2007, and January 1, 2018.

PROCEDURES

Inclusion criteria included a complete medical record that contained an anesthesia record, surgical report, available histopathology results, and results of CBC and serum biochemical analysis before surgery. A minimum follow-up of 90 days after surgery was required.

RESULTS

271 complications occurred in 171 of 459 (37.3%) dogs. Eighteen complications were not given a severity description. Of the remaining 253 complications, most were considered minor (157/253 [62.1%]). Multivariable logistic regression analysis revealed that only increased surgical time had a significant (OR, 1.36; 95% CI, 1.12 to 1.54) association with the occurrence of ≥ 1 complication. For each additional hour of surgery, the odds of complications increased by 36%. Preoperative radiation therapy or chemotherapy increased the odds of incisional dehiscence or oral fistula formation (OR, 3.0; 95% CI, 1.3 to 7.2). Additionally, undergoing maxillectomy, compared with mandibulectomy, increased the odds of incisional dehiscence or oral fistula formation (OR, 1.8; 95% CI, 1.1 to 3.1). Two hundred forty-four of 271 (90.0%) complications occurred in the perioperative period (0 to 3 months after surgery).

CONCLUSIONS AND CLINICAL RELEVANCE

Compared with mandibulectomy, performing maxillectomy increased the risk for incisional dehiscence or oral fistula formation. Mandibulectomy and maxillectomy had a moderate risk for a complication.

Contributor Notes

Address correspondence to Dr. Selmic (selmic.1@osu.edu).