Rectal Hesection in the Dog A New Surgical Approach and the Evaluation of Its Effect on Fecal Continence

Abstract

Thirteen healthy mixed breed dogs (6 female and 7 male) underwent rectal transection and resection of 0 to 6 cm using a dorsal approach. Rectoanal sphincter pressure studies were performed preoperatively and 6 weeks after surgery using a double balloon manometer device. Sphincter pressure profiles were altered in the 6 cm resection dogs. Clinical observations of defecation and degree of continence were made over a 10 week period postoperatively. The transection only and 4 cm resection dogs defecated normally. All dogs in the 6 cm resection group involving the peritoneal reflection were incontinent but retained some normal posturing behavior. Surgical complications included minor infection in two dogs, rectocutaneous fecal leakage in four dogs, breakdown of the anastomotic site in four dogs, and incontinence in all of the dogs that underwent 6 cm resections. Barium enemas were performed on the rectums postmortem to ascertain the degree of stricturing induced by the surgery. The index of stenosis measured did not correlate well with the extent of straining in each group. Histopathologic findings on dogs in the transection only and 4 cm resection groups without dehiscence showed mild granulomatous proctitis with normal myenteric plexi seen. Dogs suffering dehiscence had suppurative proctitis, necrosis, and obliteration of the myenteric plexi.

Complications and outcomes following rectal pull-through surgery in dogs with rectal masses: 74 cases (2000–2013)

“…4,6,17 Sphincteric continence involves the ability to contract the external anal sphincter to resist peristalsis in the rectum and colon. [3][4][5]17 Multiple studies 4,6,17 have been conducted to evaluate the effects of various colorectal surgeries on fecal continence. In dogs, the external anal sphincter is innervated by the caudal rectal nerve, which is a branch of the pudendal nerve.…”

“…[3][4][5][6] Thus, several approaches have been described, including the ventral approach, dorsal inverted-U approach, pull-out or rectal mucosal eversion with submucosal resection, endoscopic electrosurgical resection, and RPT (transanal or combined abdominaltransanal) approach. [3][4][5][6] Thus, several approaches have been described, including the ventral approach, dorsal inverted-U approach, pull-out or rectal mucosal eversion with submucosal resection, endoscopic electrosurgical resection, and RPT (transanal or combined abdominaltransanal) approach.…”

“…1,2,6 Advantages of this approach include good surgical exposure of the caudal and dorsal portions of the rectum and visibility of the pudendal nerve and pelvic plexus, which are essential for the maintenance of fecal continence. Soft tissue dissection involves the transection of the rectococcygeus and levator ani muscles to allow exposure of the caudal portion of the rectum.…”

MIOPLASTIA EXPERIMENTAL DO ESFÍNCTER ANAL EXTERNO COM Fascia lata AUTÓLOGA, EM CÃES

“…A emissão involuntária de fezes constitui grave complicação pós-operatória nos casos de ressecções de glândulas adanais e fístulas perianais (ANDERSON et al, 1987), herniorrafia perineal (BURROWS e HARVEY, 1977;HARVEY, 1973;BELLENGER, 1980), lesão obstétrica (KODNER et al, 1996) e prolapso retal (FOSSUM et al, 1997). Tendo em vista que na rotina são freqüentes os procedimentos com potenciais de traumatismo no músculo esfíncter anal externo, provocando emissão involuntária de fezes, faz-se necessário pesquisar procedimentos que permitam a reabilitação esfincteriana.…”

“…A incontinência fecal também é uma grave complicação pós-cirúrgica das fistulectomias perianais extensas e saculectomia anal, procedimento este indicado nas neoplasias e nos episódios de infecção e impactação das glândulas adanais (ANDERSON et al, 1987). Também LEEDS e RENEGAR (1981) citaram que a emissão involuntária de fezes pós-operatória pode estar associada com trauma cirúrgico do músculo esfíncter anal externo e nervo retal caudal.…”