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.