Introduction
Intestinal tumors represent 3% of all canine tumors, with 36-60% of these affecting the large intestine.1–4 More than 50% of colorectal tumors are malignant, with adenocarcinoma being the most common type.1,5,6 Other malignancies of the rectum include leiomyosarcoma, lymphosarcoma, hemangiosarcoma, extramedullary plasmacytoma, mast cell tumor, melanoma, and fibrosarcoma.3
Adenocarcinoma can occur in many forms including nodular, pedunculated, or annular constrictive.1,2 Single, pedunculated, or polypoid tumors are reported to have a good prognosis after surgical resection, whereas annular colorectal adenocarcinoma is associated with the shortest survival time.1,7,8 Malignant tumors require full-thickness resection with a recommended margin of at least 2-8 cm. The rectum may be exposed using a ventral, dorsal, lateral, caudal, transanal, transcutaneous, or combined approach. The choice of the approach is made according to the location, size, and type of injury.1
A transanal pull-through procedure is one of the most common surgical approaches used to resect colorectal neoplasms.6 A transanal pull-through or combined abdominal-transanal approach are well-described procedures. The postoperative complications after rectal amputation and anastomosis using a transanal pull-through procedure are tenesmus,1,9,10 stricture formation,1,9 dehiscence,6,9infection,9,10 and fecal incontinence.1,9,10 Anastomotic dehiscence usually occurs 3-5 days after surgery, can be fatal, and requires prompt intervention.3 Numerous studies in the human and veterinary literature have focused on the assessment of risk factors, prophylactic measures, and approaches to repair the dehiscence.11 A case report was recently published on the use of a temporary end-on colostomy in a dog as a rescue technique for the repair of an anastomotic dehiscence after a transanal-rectal pull-through procedure.6 The use of a colostomy has rarely been reported in veterinary medicine,6,7 likely because animal owners may not appreciate the associated fecal incontinence and postoperative care requirements.3
While the application of jejunal grafts is well-described in humans,12–15 it is not frequently used in veterinary medicine.16–18
The aim of this report was to describe the application of a jejunal graft and outcome for the repair of an anastomotic dehiscence after a transanal pull-through procedure for colorectal carcinoma, in two separate dog cases using a combined approach.