APT is a surgically created permanent stoma between the trachea and overlying skin to bypass an upper airway obstruction, and PTs are used to treat various upper airway disorders, including laryngeal paralysis, collapse, neoplasia, trauma; persistent inflammation or edema of the upper airway; and other causes of permanent laryngeal dysfunction.1–6 Substantial postoperative care is required for patients that receive a PT, particularly in the immediate postoperative period when the risk of tracheal obstruction and death is high because of increased mucus production.5,7 Postoperative complications include mucus secretion, coughing, aspiration pneumonia, and death (from asphyxiation caused by obstruction of the stoma).5,6 Revision surgery may be required if stenosis develops at the stoma site or if excessive skinfolds obstruct the stoma.2,5 Despite these risks, a PT can be an effective option for treating obstructive upper airway diseases.2,5,6
Few reports have documented the long-term outcomes in dogs with PTs. A recent study5 involving 21 dogs with PTs shows a median survival time of 328 days, noting that the initial diagnosis was not associated with survival time and that neither body weight nor sex were associated with cause of death. Major complications occurred in 10 of 20 (50%) dogs and included most commonly aspiration pneumonia (n = 5 [25%]) or obstruction of the stoma requiring revision surgery (4 [20%]).5 The most common cause of stoma obstruction in those 4 affected dogs was skinfold occlusion (n = 3), and overall, the causes of death were respiratory related in 9 of 19 dogs.5 In a study2 involving 23 dogs and 11 cats with PTs, skinfold occlusion was the most common complication (6/22 [27%]); however, the median survival time was not reported.
Given the limited data available on long-term outcomes in dogs with PTs, the purposes of the study presented here were to evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with PTs. The hypothesis was that dogs with PTs would have longer survival times than previously reported and that brachycephaly would be a predictive factor for shorter survival time.
The authors thank Tara Denley for technical assistance.
The authors declare that there were no conflicts of interest.
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